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Are we measuring the outcome of the change continuously?

Welcome to measurement, one of the eight components of the Change Model.

Measuring the outcome of change continuously is crucial to provide evidence that the change is happening and the desired results are being achieved. This component covers the requirement to have effective measurement of outcomes and outputs, how measurement works, including the difference between measurement for improvement, for judgement and for research. It also covers the need to identify and collate relevant data.

Using appropriate measurement techniques ensures that success can be celebrated, remedial action can be taken to mitigate risk and the unforeseen consequences can be dealt with promptly. At the start of any change it is important to plan for expected benefits and return on investment as the change progresses benefits realised must be measured to demonstrate the effectiveness of the change. Making data available to the public increases patient power and choice and, ethically, it is the right thing to do. Comparative data, in particular, is a key driver for change.

Resources to support this component - measurement

Measurement frameworks for large scale change

The NHS Institute's Leading large scale change - A practical guide tells the story of what the NHS Academy for Large Scale Change learnt and how you can apply these principles within your own health and healthcare setting. Chapter three gives measurement frameworks for large scale change.

The one-hour improvement expert - How to Become an Improvement Measure Expert in 60 Minutes and the A-Z of measurement

This guide is designed to offer an interactive introduction to the topic of improvement measurement, and features signposting to experts and key resources. 

Seven steps to measurement

This short video describes seven key steps to effective measurement.

Evidence and evaluations

QIPP evidence 

This website, collated by the NICE, gives many examples of good practice.

Measuring safety culture 

This evidence scan from the Health Foundation provides a brief overview of some of the tools available to measure safety culture and climate in healthcare.

Overcoming challenges to improving quality

Lessons from the Health Foundation's improvement programme evaluations and relevant literature. Identifies 10 key challenges to improvement and suggests ways to overcome them. The following is relevant to the theme of Measurement: Challenge 3: Getting data collection and monitoring systems right. This always takes much more time and energy than anyone anticipates. It's worth investing heavily in data from the outset. External support may be required. Assess local systems, train people, and have quality assurance.

Engagement cycle case studies where return on investment has been measured

Advice on how to involve patients in measuring their experience.

Manchester Patient Safety Assessment Tool

The Manchester Patient Safety Framework (MaPSaF) is a tool to help NHS organisations and healthcare teams assess their progress in developing a safety culture. MaPSaF uses critical dimensions of patient safety and for each of these describes five levels of increasingly mature organisational safety culture.

The dimensions relate to areas where attitudes, values and behaviours about patient safety are likely to be reflected in the organisation's working practices. For example, how patient safety incidents are investigated, staff education, and training in risk management. There are different tools for different health sectors.