measurement and data collection: clear kick-off event
Post on 05-Dec-2014
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DESCRIPTIONThis presentation was delivered by Andrew Wray, director of learning and strategic initiatives for the BC Patient Safety & Quality Council, at the kick-off event for CLeAR on October 9, 2013. The aim of CLeAR – our Call for Less Antipsychotics in Residential Care – is to achieve a reduction in the number of seniors in residential care on antipsychotic medications by 50% across BC by December 31, 2014 through a province-wide, voluntary initiative that supports participating sites. Learn more at www.CLeARBC.ca.
- 1. HOW WILL WE KNOW WEVE MADE AN IMPROVEMENT: MEASUREMENT AND DATA COLLECTION
2. Agenda Improvement Measurement Basics Family of measures Data over time CLeAR outcome measures and data collection tool Creating measures for the ideas being tested 3. Improvement Measurement Why do we measure?To show if the changes we are testing are making things better 4. Family of Measures Measuring improvement will usually need a family of measures: Process Outcome Balancing 5. Outcome measures What are we trying to accomplish? What is ultimately better? What will we tell our residents and their families? 6. Process Measures What are you changing is it really happening? Voice of the system what is being done differently? Processes improve more quickly than outcomes 7. Balancing Measures What are the unintended consequences that might occur? What are we worried about that we can do something about? 8. A Run Chart: Building Block of Measurement for Improvement Percent of residents on less than 5 medicationsData displayed in time order100%80%Data is collected and displayed weekly or monthly.60%40%20%0% AprilMayJuneJulyAugSeptOctNovDecJan9 9. No improvement. Random fluctuation.Improvement. Trend going down.Improvement. Trend going up. 10 10. The Value of Data in Real TimeRun Charts can tell us what is happening in real time.Percent of residents on less than 5 medications 100%80%60%40%20%0%11 11. The Value of Data Over TimeRun Charts detect true patterns and trends over time.Percent of residents on less than 5 medications 100%80%Not just what is happening before and after a change.60%40%20%0%12 12. Pre and Post Change Bar Chart What is the Interpretation? 13. Scenario 1Scenario 1 . Pre-post data.10 8 6 4Scenario 1 . Data displayed in a run chart over time.2 0change made between week 7 and 8 14 14. Scenario 2Scenario 2 . Pre-post data.10 9 8 7 6 5 4 3 2 1 0Scenario 2 . Data displayed in a run chart over time.change made between week 7 and 8 15 15. Scenario 3Scenario 3. Pre-post data.Scenario 3. Data displayed in a run chart over time.change made between week 7 and 8 16 16. CLeAR Outcome Measures 1) Percent of residents with physicians order for antipsychotic. 1a) Percent of residents with physicians order for regular antipsychotic. 1b) Percent of residents with physicians order for PRN antipsychotic. 3) Total Number of BPSD related incidents. 17. Measuring the changes being tested Will need to measure each of the ideas being tested. A few things to decide: What to measure How frequently How many to measure How to collect and display Who will collect the data 18. Example #1 Change idea: Enhanced education about dementia and BPSD for all staff Test: running a couple of 20 minute education session for staff taught by Chris 19. Measures 1) Ask participants if they learned new information. (outcome) What to measure - did participants learn something new How frequently each education session How many to measure - all How to collect Raise of hands Who will collect the data - Chris2) Number of people who attend (Process) What to measure - Number of people How frequently each education session How many to measure - all How to collect Count at the end of session Who will collect the data - Chris 20. Example #2 Change idea: Reduce number of medications (pill burden) Test: Use the polypharmacy algorithm and antipsychotics drug sheet to review the medications of 10 residents. 21. Measures 1) Number of medications discontinued (outcome) What to measure number of medications discontinued for each patient How frequently each patient How many to measure 10 How to collect checksheet, during medication review Who will collect the data - Keith2) Time to review medications(Process) What to measure Time spent on review How frequently each patient How many to measure 10 How to collect clock, checksheet Who will collect the data - Keith 22. Measures 3) Number of medications restarted. (balancing) What to measure number of medications restarted within 1 month How frequently each patient How many to measure 10 How to collect Chart review Who will collect the data - Chris 23. Your turn!