Sourcebook : 2.3 How to avoid common problems

Having no data is a problem. Unfortunately, good work will not stand on its own merits. If the team cannot describe the effect of the changes it has made, it will not be able to continue with the good ones or recognize the bad ones. And, as mentioned above, teams need to avoid the comfortable niche of measuring so much that they don't have time to make much happen. We find it a useful rule of thumb to allocate energy this way: "If you have five units of energy to spend on making improvement, use four on change and one on measurement." Be sure not to use much less on change or much more on measurement.

• See problem 1 (Studying the problem too long)
• Track at least one indicator over time. Measure it at least monthly.
• Use "subjective" data. Ask two or three physicians every month how the pain protocol is working out for them. Ask one or two patients every day how they feel about the planning discussion. Especially as an interim step, these responses will be useful for identifying problems and will also spur you to further (useful) data collection.

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