A PRACTICAL GUIDE TO QUALITY IMPROVEMENT FOR BURN CARE in Low-Resourced Settings
STEP 6: MEASURING THROUGHOUT
As mentioned in Step 3: Understand the Problem, you should plan to measure your change in order to identify if improvements are being made and if not, where you might need to re-consider your approach. During a quality improvement project you should collect data at a number of points. COLLECTING DATA only at the beginning and end, as you might see in a typical research project, will not be enough as you may need to make ADJUSTMENTS to your plan if you are not seeing an improvement, or in some cases you may need to stop the change if it is having a negative impact on the problem. When considering how you will measure your project results you need to think about: • How you will know whether or not you have achieved the desired outcome; • What information is currently available or could be easily collected These measures might include audits, patient feedback and/or observations. You will need to consider which is most appropriate and the key strengths and limitations of each method.
Common pitfalls with measurements: • Measuring too few variables – therefore not being able to demonstrate change has happened. • Measuring too many variables – getting confused results when not all variables are relevant to the change. • Not measuring frequently enough – means you have no chance to adapt your strategy throughout the project.
For your project, you need to decide:
In each of these examples nurses had to review and change an element of what they were measuring to make sure that they were measuring the right things , at the right time . • Which measurement tools are the best to investigate the change? • What are you going to measure? • How often are you going to measure?
Example of not measuring specifically enough: Olive & Ziphilly describe their measurement tool:
Olive & Ziphilly started with 10 different indicators that they
• Same checklist used to collect baseline data was used for measuring change progress; • A QI team checked patients observation charts in the files against the checklist tool which contained 15 indicators. • Data was collected using a data collection tool using a scoring system of 0, 1, 2 for every indicator and then put in a graph. • Data was collected every two weeks. • The tool was able to identify progress on every indicator and also helped to identify areas to focus change interventions.
were measuring. They found that the indicators
that they included were not specific enough to identify the precise areas which needed to be considered to improve documentation.
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