This Block highlights the importance of getting the right data delivered, in the right format, time and place.
Real-time measurement means frequently collecting and processing data as close to the point of care as possible. High quality measurement is critical to any effective learning system, and ideally should be automated to minimise the burden on staff.
Having real-time data available to staff can help them to rapidly understand if improvements have had an effect, or give early indications of deterioration.
Benchmarking and Red Amber Green (RAG) scales are usually of limited use as a guide to an improvement project and learning system. Natural variation occurs in processes within any complex system, therefore basic skills to analyse statistics are vital in order to interpret real-time data.
Time series is the gold standard in analysis of improvement data, and run charts are the simplest way to achieve robust statistical analysis, without losing valuable information from aggregation.
Transparent use of measurement and effective visualisation of data, can be a powerful mechanism to help engage staff in improvement. In most cases, transparency means publishing updated charts and progress on publicly accessible areas, either physically or electronically.
Once capable and motivated staff have access to reliable real-time data, against which they can measure and demonstrate the effect of their innovation efforts, improvement can be expected to follow.
Analysis of data and the development of data systems requires basic statistical and technical training.
Consider who and how your business intelligence team may be provided this as part of capacity building with a plan to include basic measurement training for all staff involved in leading improvement projects.
Directives to take forward:
Automatically collect and code data as close to real-time as possible – ideally within one time unit (hour, day, week, month) of specified analysis and the shorter time unit the better (up to a maximum of 1 month).
Include meaningful measures – data within projects should consistently include meaningful measures such as outcome, process and balancing measures.
Use time series data – projects and system measures data should be consistently presented in a time series, as well as analysed using ratified statistical process controls.
Make the data visible to others – data summaries on current improvement work should be displayed throughout the organisation within public-facing areas.
Case Study: The Perfect Ward app at Barnsley Hospital
The Perfect Ward app can be used to simplify ward assessments. It can be used on users’ smartphones or tablets which in turn reduces the need for paper and free up nursing staff time. The app makes clear the standards expected and provides instant, transparent feedback which means that quality can be improved across an organisation.
Using the Perfect Ward app greatly improves this process; the app is easily accessible for staff, the method of storing information is structured and easy to analyse, users are able to add photos and comments where appropriate, there is no need to write up information as it is all stored on the app and users are able to get a real insight into the details of all inspections.
At Barnsley Hospital NHS Foundation Trust Perfect Ward has received excellent feedback from staff across the Trust who have used it. The hospital is already benefitting from using this innovative new technology to assess areas. In the first month of using Perfect Ward, Barnsley Hospital saw an increase of over 50 per cent in the number of inspections undertaken.
Case Study: South Sefton Care Home Improvement Project
South Sefton Care Home Improvement Project (CHIP) used a run chart dashboard built from MS Excel to guide progress and define success. Although an element of manual collation was required, this method is cheap and straightforward.
The dashboard is used to anchor progress at the work stream where review of process measures enabled a vigilant response to variation e.g. televideo use, training attendance etc. This contributed in turn to ratified success within outcome measures. Sharing the dashboard with care homes facilitated momentum for the project.