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Jade constructing a measurement
- 1. Constructing a measurement “Measurement assists the achievement of practice goals, but doesn't determine goals.”
- 2. Standards for expression The standard expression of quality measures, involves a numerator & denominator Number of staff, complying to PPE guidelines Number of staff, present
- 3. Baseline measurement Multiple • Indicators sources of data • Allow analysis • Determine the change in the time Evaluation following • Only a snapshot Shortcomings • Doesn’t indicate sustained improvement
- 4. Trending measurements Run chart Control chart Trigger tools
- 5. Benchmarking Appropriate Attainable & sample measurable number Based on the achievements
Notas del editor
- Quote sourced from:Varkey, P. (Ed.). (2010). Medical quality management: Theory and practice. Constructing a Measurement (pp. 32-37). Sudbury, MA: Jones and Bartlett Publishers.
- Standards for expression of quality measuresComparisons of quality measures within systems, requires standards for how quality measures are expressed. The standard for expression of quality measures, involves a numerator & denominator. Numerator, denotes the desired characteristics of care & Denominator, identifies the sample.Eg. Numerator- Number of staff who are complying to PPE guidelines, in a specified area Denominator- Number of staff present, in the specified areaTogether, this information in this standard expression, gives an insight into the quality of PPE compliance in the specified area.Several factors should be considered when constructing a measure of quality. IE. the system being examined, duration of measurement, is it local to a system or on largescale (ward, or the larger organisational unit such as a hospital/the entire health care system).. The following slide will discuss strategies to be considered when constructing measures of quality.----------------------------------------------------------------------------------Information sourced from:Varkey, P. (Ed.). (2010). Medical quality management: Theory and practice. Constructing a Measurement (pp. 32-37). Sudbury, MA: Jones and Bartlett Publishers.
- To implement a quality improvement project or initiative effectively, a measurement of quality in it’s current state is required- known as a baseline measurement. Baseline measurements use multiple sources of data as indicators & allow supporting analysis for a decision to be made about the status of quality at that point in time. The evaluation of a baseline measurement can be utilised to design a QI initiative & determine the change, in the time following the initial intervention.The shortcoming of a baseline measure is that, only a ‘snapshot’ of measured characteristics is acquired, from one point in time. Measurement at another time can only be interpreted as being higher/lower than the baseline, which does not represent or indicate sustained improvement. This is where tools allowing for trending can be applied & benefit in the analysis of data to then interpret the improvement with increased precision.------------------------------------------------------------------------------------Information adapted from:Varkey, P. (Ed.). (2010). Medical quality management: Theory and practice. Constructing a Measurement (pp. 32-37). Sudbury, MA: Jones and Bartlett Publishers.
- Run chart – Is a quality tool used to identify trends by measuring changes (in structure, processes or outcomes) over time. The chart is created in an XY graph , where the X-axis represents time & the y-axis represents the measurable aspect. Any central line, indicates the median amongst the data. A run consists of consecutive points above/below the median line & indicates a shift in the measure being examined. Any gradual inclinine/declining progression of points, indicate a steady change over time.Control charts- Are focused on process variation (or rather, a different way of doing things). They include additional features to detect standard deviations from the mean – (mean value & upper/lower control limits) A statistical control chart, such as a Statistical process control chart, represents the continuous application of measurement, to distinguish between normal & abnormal variations.Trigger Tools- A trigger is an event that has the potential to cause damage within a system & the event initiates further study. Trigger tools allow the opportunity to examine quality issues that have been identified through less rigorous measures, such as self report. An example of this in relation to nurses & other health professionals working within a ward setting is an incident report form. The use of trigger tools such as the incident report form allow ‘near-miss’ events that do not result in harm to be included in the statistical data.WHAT I’VE DISCOVERED- Run charts are similar in some regards to the control charts used in statistical process control, but do not show the control limits of the process. They are therefore simpler to produce, but do not allow for the full range of analytic techniques supported by control charts.--------------------------------------------------Information adapted form:NHS Institute for Innovation and Improvement. (2008). Statistical Process Control (SPC). Retrieved January 9, 2012, from NHS Institute for Innovation and Improvement : http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/statistical_process_control.htmlVarkey, P. (Ed.). (2010). Medical quality management: Theory and practice. Constructing a Measurement (pp. 32-37). Sudbury, MA: Jones and Bartlett Publishers.Government of Western Australia: Department of Health. (2012). Clinical incident reporting tools . Retrieved January 11, 2012, from Office of safety and quality in healthcare : http://www.safetyandquality.health.wa.gov.au/clinical_incid_man/clinical_incident_report.cfmImages sourced from:http://upload.wikimedia.org/wikipedia/commons/d/df/SimpleRunChart.jpghttp://www.google.com.au/imgres?q=control+chart&um=1&hl=en&sa=N&qscrl=1&nord=1&rlz=1T4ADFA_enAU367AU368&biw=1366&bih=556&tbm=isch& tbnid=GdmlbyEm2OREdM:&imgrefurl=http://en.wikipedia.org/wiki/Control_chart&docid=nk5GQFPro_UpEM&imgurl=http://upload.wikimedia.or g/wikipedia/commons/thumb/f/f7/ControlChart.svg/520px-ControlChart.svg.png&w=520&h=244&ei=anwNT_XQA_Ta4QSHm7SwBg&zoom=1
- Benchmarking- is an effort to determine the current status of quality and compare it to the highest performers internal to an organisation or external to organisation (comparing hand hygiene compliance between two or more hospitals)An achievable benchmark of care according to Kiefe et al. Is produced by benchmarks that are;Attainable & measurableProvides an appropriate sample number of cases for analysisBased on the achievements of the highest performing unit/organisation --------------------------------------------------------------Information adapted from:Varkey, P. (Ed.). (2010). Medical quality management: Theory and practice. Constructing a Measurement (pp. 32-37). Sudbury, MA: Jones and Bartlett Publishers.Image sourced from:http://www.google.com.au/imgres?q=hospital+comparison&um=1&hl=en&qscrl=1&nord=1&rlz=1T4ADFA_enAU367AU368&biw=1366&bih=556&tbm=isch&tbnid=06_9ufwMxo4VlM:&imgrefurl=http://www.borders.com.au/book/aha-hospital-statistics-the-comprehensive-reference-source-for-analysis-and-comparison-of-hospital-trends/4328572/&docid=w7VUE1PnTqKL4M&itg=1&imgurl=http://images.borders.com.au/images/bau/97808725/9780872588448/0/0/plain/aha-hospital-statistics-the-comprehensive-reference-source-for-analysis-and-comparison-of-hospital-trends.jpg&w=400&h=519&ei=mYANT-GuEeT24QS975WyBg&zoom=1