Measurement Strategies for Improving the Quality of Care

The Measurement Strategies Report provides a summary of successful measurement systems from around the world and how these systems have been used to improve the quality of healthcare. This report was developed with input from the Measurement and Indicators Working Group.

Key Points:

  1. Measures Reflect the Current System

    Measurement within a healthcare system or organization should use a framework, such as a dashboard or balanced scorecard, to reflect multiple dimensions of quality and a comprehensive view of the system. All indicators on a dashboard should reflect current strategic objectives or priority areas for the organization.

  2. Measurement Throughout the Organization

    The identification of indicators should involve multiple levels of the organization, with senior leaders ensuring that indicators reflect the strategic goals set out by the organization, and front-line clinicians and staff ensure the measures are workable and reflective of their environment.

  3. Cascade of Measures

    A cascade or roll-up of indicators is encouraged so that measures collected at front-lines (micro level) are related to those indicators that are reviewed and reported to senior leaders (macro level). This approach reduces the burden of data collection; only measures that are meaningful for decision making, or are directly related to priority areas for improvement, are collected. System measures, that span time frames and specific sectors of care or service lines, should be provided for senior leaders.

  4. Use of Real Time Data to Drive Improvement

    Indicators should use real-time data wherever possible to ensure that priorities and decisions are based on the current performance. Indicator results should also be communicated throughout all levels of the organization, along with opportunities for dialogue on the results.

  5. Appropriate Data Display

    Displaying data over time, and analyzing the data using statistical process control methods, are the preferred methods for understanding data and performance. Senior leaders should be given information through data display techniques, analysis, or comparative targets and benchmarks, to understand the performance of their organization.

  6. Plan of Action

    Measuring and reporting is only one part of a system designed to use data for improvement. Managers and leaders also need a routine set of practices to ensure they act on data that is provided. Leaders are accountable to implement rapid “course corrections” when the data indicates a need to do so, and are responsible for setting priorities for improved performance when indicator results fall short of targets.

For more information please contact:

Jill Veenendaal

Quality Leader, BC Patient Safety & Quality Council

email: jveenendaal@bcpsqc.ca