Sourcebook : 2.3 How to avoid common problems

Teams that spend more than four weeks collecting baseline information are stuck. If discussions about data collection dominate team meetings, the team has fallen into an information abyss.

• Use simple sampling techniques such as "every fifth patient" or "on every Tuesday and Thursday afternoon" for data collection that is good enough.
• Use one or two indicators of the results. For example, including family satisfaction with care may be enough to show that a new communication strategy is working. It would not likely be worth the effort to add ten more measures just to determine whether a change is an improvement.
• Use available resources. Use paper and pencil methods rather than waiting for the information system to put out the data needed, or use that electronic data if it has what the team needs! Sometimes teams use the electronic data to get the "denominator" and another source to get the numerator. (For instance, the percentage of patients discharged from the hospital with heart failure who receive supportive care services.)
• Integrate data collection with the daily routine. Making pain a fifth vital sign is an excellent example of building a key measure into everyday practice. So is charting on a flow sheet that can be used for data collection, or keeping a check sheet to mark off events (such as referrals to palliative care).
• Use a related measure as a "proxy." If the team cannot measure continuity directly, measure how many different providers see the patient in one day or one week, or the numbers of families who report not knowing who to call in with questions about patient care.

This text is derived from the book Improving Care for the End of Life : A Sourcebook for Health Care Managers and Clinicians.