The Common Sense Guide to Improving Palliative Care > Assuring Comfort > 5.5 Measuring Success

Sick To Death book cover This extract from the online edition of The Common Sense Guide to Improving Palliative Care is used with permission.

Measuring Success

How do you turn abstract ideas into measurable aims? In rapid-cycle quality improvement (QI), three kinds of measures work best to track whether changes are actually improvements: process, outcome, and adverse effect.

We recommend that you choose one key measure to track your progress; once underway, consider adding one or two others. The nature of your project is likely to drive decisions about the type of data to collect. Your team needs to decide who will collect the data and when, as well as how to sample the data (see Chapter 2 for more details on measures). Depending on the number of patients you treat, you might not have enough time to get data about every patient. If so, you will want to pick a sample for your study. Team Breathe-Easy, for instance, might track everyone discharged in the first 10 days of each month. You might find that your baseline data can be obtained through the IT department and in records already maintained, such as hospitalization dates. In addition, your team will have to decide how frequently to collect data: daily, weekly, monthly, or quarterly.

Each QI team will develop its own measures -- and may be surprised by how many ways it can track a project. The following process, outcome, and adverse-effect measures can be used for Team Breathe-Easy's work:

Process Measures

Outcome Measures

Adverse-Effect Measures

Team Breathe-Easy decided to collect outcome-measure data monthly and solicited reports of any adverse effects. They tracked the core outcome measure for one year.

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