While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
Track the unit's progress on meeting a series of specific measures the TCAB team develops.
Why It's Important:
The nature of TCAB as an integrated, multifaceted approach rooted in four themes (Patient-Centered Care; Care Team Vitality; Reduction of Waste; Safety and Reliability) lends itself to participating hospitals developing a set of measures to gauge progress. When establishing measures, it's important to determine the desired outcome from looking at the design target.
How To Do It:
When establishing measurements for new tests of change, it's important to start with simple measures that will demonstrate if the idea is working or not.
1. Compute a baseline. In order to determine the impact of transformational changes, baseline data should be collected, if possible, before the test of change begins.
2. Establish quantitative measures for a test of change such as outcome measures, process measures and/or diagnostics.
3. Keep it simple. The goal of the test of change is not to measure it but to make an improvement. Keep measurements simple enough to gather data to determine if an innovation works without being burdened with excess data to gather and analyze.
4. Determine qualitative measures, which are also important, such as success stories, anecdotes and testimonials from patients and staff. Qualitative data can be key in helping refine an idea because there is a good baseline of understanding how well a test is working.
5. Track staff perceptions on their sense of vitality and engagement in quality improvement as a result of participating in the TCAB process.
6. Track turnover rates on medical surgical units that participate in TCAB for registered nurses and licensed practical (vocational) nurses.
Tip: Other measures to track include:
- Clinical outcome measures for the key target populations (using publicly reported "core" measures where appropriate)
- Prevalence rates for falls and pressure ulcers
- Percentage of "top box" positive responses to the patient satisfaction responses for whether or not the patient "would recommend" the hospital to a friend or family member
- Measures of clinical efficiency
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