measurement for improvement n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Measurement for Improvement PowerPoint Presentation
Download Presentation
Measurement for Improvement

Loading in 2 Seconds...

play fullscreen
1 / 41

Measurement for Improvement - PowerPoint PPT Presentation


  • 95 Views
  • Uploaded on

Measurement for Improvement. Turn to your neighbor. What have been your biggest learnings or challenges regarding data gathering and measurement for your Early Years work? Definitions Collection Reporting Frequency Analysis Other?. Components of a Learning System . System level measures

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Measurement for Improvement' - gitel


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
turn to your neighbor
Turn to your neighbor
  • What have been your biggest learningsor challenges regarding data gathering and measurement for your Early Years work?
    • Definitions
    • Collection
    • Reporting
    • Frequency
    • Analysis
    • Other?
components of a learning system
Components of a Learning System
  • System level measures
  • Explicit theory or rationale for system changes
  • Segmentation of the population
  • Learn by testing changes sequentially
  • Use informative cases: “Act for the individual learn for the population”
  • Learning during scale-up and spread with a production plan to go to scale
  • Periodic review
  • People to manage and oversee the learning system

From Tom Nolan PhD, IHI

slide4

The Model for Improvement

Act

Plan

Study

Do

What are we trying to

Accomplish?

The three questions provide the strategy

Our focus today

How will we know that a

change is an improvement?

What change can we make that will result in improvement?

The PDSA cycle provides the tactical approach to work

Source:

Langley, et al. The Improvement Guide, 1996.

the quality measurement journey
The Quality Measurement Journey

AIM(How good? By when?)

Concept

Measures

Operational Definitions

Data Collection Plan

Data Collection

Analysis

PDSA

Source: R. Lloyd. Quality Health Care: A Guide to Developing and Using Indicators. Jones and Bartlett, 2004.

case study
Case Study
  • Promoting Bedtime Reading
  • Lochrin and Grassmarket Nursery Schools
  • Edinburgh
  • Lead: Donna Murray
the quality measurement journey1
The Quality Measurement Journey

AIM– Improvebedtime routines, attachment, literacy

Concept – Increase bedtime reading

Measures– Percentage of children receiving a bedtime story

Operational Definitions– Number read story/Total Children

Data Collection Plan – daily; no sampling

Data Collection – teacher asks parents at drop off, spreadsheet

Analysis– run chart

PDSA

slide8

WORKSTREAM 3 (30 months to start of primary school)

Theory of what actions will ensure developmental milestones are reached at the start of primary school

Theory of what drives developmental milestones

2⁰

Aim

1⁰

Improved teamwork, communication and collaboration

Poverty

Quality Of Home Environment

Improved uptake of benefits

Domestic Abuse & Violence

Improved child’s dental health

Societal Issues

Workforce Issues

Improving child nutrition

Transport, Community Capacity & Cultures

Children have all the developmental skills and abilities expected at the start of primary school

Improving brain development and physical play

Access To Services

Employment

Improved family centred response

Early Learning & Play

Improved stability / permanence for LAC

Child’s physical & mental health and emotional development

Health

Improved identification

Attachment

Improved joint working

Detailed Aim:

90% of all children within each CPP have reached all of the expected developmental milestones at the time the child starts primary school, by end-2017

Additional Support

Improved management, planning and quality of services

Level of education

Misuse of alcohol & drugs

Improved sharing of information

Carer’s physical & mental health and skills

Nutrition

Improved leadership, culture & planning`

Disabilities & Mental health

Identification & reasons for current resilience

Parenting skills & knowledge

Version: 06/03/2013

the quality measurement journey2
The Quality Measurement Journey

AIM(How good? By when?)

Concept

Measures

Operational Definitions

Data Collection Plan

Data Collection

Analysis

PDSA

Source: R. Lloyd. Quality Health Care: A Guide to Developing and Using Indicators. Jones and Bartlett, 2004.

project aim statements
Project Aim Statements
  • What, by when, by how much.
    • “By the end of June, 90% of children at Grassmarket Nursery will receive a bedtime story at least 3 times a week.”
the quality measurement journey3
The Quality Measurement Journey

AIM(How good? By when?)

Concept

Measures

Operational Definitions

Data Collection Plan

Data Collection

Analysis

PDSA

Source: R. Lloyd. Quality Health Care: A Guide to Developing and Using Indicators. Jones and Bartlett, 2004.

slide12

WORKSTREAM 3 (30 months to start of primary school)

Theory of what actions will ensure developmental milestones are reached at the start of primary school

Theory of what drives developmental milestones

2⁰

Aim

1⁰

Improved teamwork, communication and collaboration

Poverty

Quality Of Home Environment

Improved uptake of benefits

Domestic Abuse & Violence

Improved child’s dental health

Societal Issues

Workforce Issues

Improving child nutrition

Transport, Community Capacity & Cultures

Children have all the developmental skills and abilities expected at the start of primary school

Improving brain development and physical play

Access To Services

Employment

Improved family centred response

Drivers

Concept:

Bedtime Reading

Early Learning & Play

Improved stability / permanence for LAC

Child’s physical & mental health and emotional development

Health

Drivers

Improved identification

Attachment

Improved joint working

Detailed Aim:

90% of all children within each CPP have reached all of the expected developmental milestones at the time the child starts primary school, by end-2017

Additional Support

Drivers

Improved management, planning and quality of services

Level of education

Misuse of alcohol & drugs

Improved sharing of information

Carer’s physical & mental health and skills

Nutrition

Improved leadership, culture & planning`

Disabilities & Mental health

Identification & reasons for current resilience

Parenting skills & knowledge

Version: 06/03/2013

driver concept and measure
Driver Concept and Measure
  • Measures to provide feedback on the concept
    • % receiving a story
    • % of stories read at bedtime
    • % of parents reporting improved bedtime routine
    • % enjoying the bedtime story
    • % reporting increase in bedtime story reading
the quality measurement journey4
The Quality Measurement Journey

AIM(Why are you measuring?)

Concept

Measures

Operational Definitions

Data Collection Plan

Data Collection

Analysis

PDSA

Source: R. Lloyd. Quality Health Care: A Guide to Developing and Using Indicators. Jones and Bartlett, 2004.

operational definitions
Operational Definitions
  • What does reading a story mean?
  • When is bedtime versus other time?
  • What is improved bedtime routine?
  • What is the definition of enjoyed?
the quality measurement journey5
The Quality Measurement Journey

AIM(Why are you measuring?)

Concept

Measures

Operational Definitions

Data Collection Plan

Data Collection

Analysis

PDSA

Source: R. Lloyd. Quality Health Care: A Guide to Developing and Using Indicators. Jones and Bartlett, 2004.

data collection planning doing
Data Collection Planning & Doing

All children are included, no sampling. 7 days a week.

Donna will inquire with each parent at drop off Monday through Friday.

Data will be captured on a paper form.

Donna inputs daily data into spreadsheet following drop off.

the quality measurement journey6
The Quality Measurement Journey

AIM(Why are you measuring?)

Concept

Measures

Operational Definitions

Data Collection Plan

Data Collection

Analysis

PDSA

Source: R. Lloyd. Quality Health Care: A Guide to Developing and Using Indicators. Jones and Bartlett, 2004.

analysis run charts
Analysis – Run Charts

weekly average displayed for parents

Research information handed to parents.

Books available at collection time.

Grassmarket changes introduced.

the quality measurement journey7
The Quality Measurement Journey

AIM(Why are you measuring?)

Concept

Measures

Operational Definitions

Data Collection Plan

Data Collection

Analysis

PDSA

Source: R. Lloyd. Quality Health Care: A Guide to Developing and Using Indicators. Jones and Bartlett, 2004.

background
Background
  • NHS Lanarkshire Clinical Quality Service, supporting both North and South Lanarkshire CPPs from a health perspective
  • 27-30 month reviews commenced June 2013 in Lanarkshire – measurement data for stretch aim 2
  • But we don’t have baseline data…….
  • ….so we need early access to our review data to develop a baseline…….
  • ISD Proposed quarterly reports…….November 2013 before we see our first set of results
accessing our data lots of questions
Accessing our data – lots of questions....
  • Where do the forms go?
  • Does anyone in Lanarkshire have access to the CHSP system?
  • Can we access the system?
  • Technical challenges accessing the system....patience.......patience........we’re in!!
  • We’re in but what do all these codes mean?
  • Expertise to interrogate the data
how did we access chsp business objects universe aka our data
How did we access CHSP Business Objects Universe (AKA – our data)?
  • Contact the ATOS Helpdesk ITServiceDesk.NHSS-NS@Atos.net
  • Receive a form to complete via email, needs authorising by your Child Health Administrator
  • Receive complex instructions from ATOS on how to set-up your PC/laptop – stick with it, you’re getting there!!
  • Receive your Business Objects Universe login and password from your local Child Health Administrator
benefits of accessing our data
Benefits of accessing our data
  • Earlier access to our data – some delays come from the time to return the forms for data entry and data entry itself (approx 4 weeks)
  • Early identification of quality issues with form completion enabled us to feed this back and engage with staff
  • We have early baseline data
  • Stratify the data as we like (unit, locality, team)
  • Results are helping us identify early tests of change
early data focus
Early data focus
  • Meaningful reviews (9 developmental milestones reviewed and recorded)
  • Stretch aim 2 (meeting all developmental milestones)
  • Future actions (request for assistance/referral)
  • Looked After Status
  • Breeches
  • Health Plan Indicator (HPI) – status change
  • Attendance / DNA – obtained locally
coverage a work in progress
Coverage – A work in progress:

A national definition of ‘eligible children’ in a reporting period is still in development.

Eligible = denominator/starting point

Invited: coverage measure 1

Attended: coverage measure 2

Meaningful: coverage measure 3

examples of our early data
Examples of our early data

(p) Provisional data - incomplete

limitations of our early data
Limitations of our early data
  • We’re still developing a robust process to measure uptake - so results are only representative of those attending
  • Non attenders are potentially our more vulnerable children and this may be skewing our results – particularly stretch aim 2
  • Non-meaningful reviews are being excluded, we need to reduce this (approx 25%)
stage 2 data focus
Stage 2 data focus
  • What other data is available from the review?
    • Age of child at review
    • SIMD quintiles
    • Ethnicity
    • Place of review (home, GP practice, clinic)
    • Exposure to smoke
    • Registered with a dentist
    • Bi/Multi-lingual
monthly reports
Monthly reports

Monthly summary and locality level reports are in development

next steps
Next steps
  • Continue to work with colleagues to develop reporting that is meaningful and facilitates/guides improvement
  • Continue to feedback real time issues with data completeness and quality
  • Further work to link other reviews and develop data intelligence over time for each child e.g. HPI
  • Further work to consider how best to share this data with partners out with health to benefit children and families
thank you i hope that didn t leave you feeling like this or this
Thank you. I hope that didn’t leave you feeling like this...................or this.......
i hope it did make you feel like this
I hope it did make you feel like this.....

Thank you to Scott Purdie, Clinical Quality Co-ordinator, NHS Lanarkshire for his work in this area.

And

My niece Emily, age 9 months for brightening up the data talk!

Stacey.rooney@lanarkshire.scot.nhs.uk