Steps to Improvement: Measures and Changes

by Laura Yoshitani, Workplace Effectiveness Consultant and
Catalyst Consulting Group Associate

This is the second article in a 3-part series about the Model for Improvement, a framework for learning and quality improvement. Click here for the first article.

 

Model for Improvement

Catalyst Consulting Group is using the Model for Improvement, developed by Associates in Process Improvement, to guide nonprofit caregiver services organizations to improve the effectiveness of their programs and processes.

The Model combines three fundamental improvement questions with Plan-Do-Study-Act cycles for testing and implementing changes. The questions help organizations identify problems and opportunities for improvement, focus the scope of their efforts, and define specific measures of success. The Plan-Do-Study-Act cycles provide the means for turning ideas into action. They facilitate learning and implementation by testing ideas on a small scale.

This first article covered the improvement question “What are we trying to accomplish?” This second article in our three-part series will discuss the remaining two questions: “How will we know that a change is an improvement?” and “What changes can we make that will result in improvement?” The final article in the series will explain the Plan-Do-Study-Act cycles.

Measures

How will we know that a change is an improvement?

Not all change is an improvement. Before making any changes, it is important to define the ways that you will show progress toward your aim. For some projects, you may be able to tell if things are improving simply by observing the system. However, for larger, more complex systems, the use of measurement and data is necessary to determine improvement.

The specific measures you choose will depend on what information is important to your organization, as well as what information is available. Measures should be simple enough to collect over short intervals, such as days, weeks, or months so you can see if your improvement initiatives are making a difference.

Progress toward a particular improvement aim may be measured in a variety of ways. The table below shows examples of measures for a few common aims.

Example Aim Possible Measures
Improve client satisfaction

 

Increase…
·         Client survey ratings of satisfaction with services or products
·         Number of clients who return for more services or products
·         Number of new customers who were referred by another customer

Decrease…
·         Number of complaints received from clients
·         Number of clients who drop out of a program

Improve the quality of services or products Increase
·         Client ratings of the quality of services or products
·         Number of products or services that meet a given quality standard

Decrease
·         Number of errors or defects
·         Time spent on rework to correct errors

Improve productivity Increase…
·         Quantity of products designed, manufactured, sold, or delivered
·         Number of client contacts (calls, meetings, visits)

Decrease…
·         Usage or cost of physical resources (fuel, office supplies, electricity)
·         Labor costs such as overtime or temporary staff
·         Lost work time due to employee injury or illness

Changes

What changes can we make that will result in improvement?

This question helps identify new methods or procedures to test. Change ideas come from creative thinking, an understanding of work processes and systems, and knowledge of general change concepts.

A change concept is a notion or approach to change that others have found to be useful in developing specific ideas that lead to improvement. The change concepts below are a few of the examples developed by Associates in Process Improvement.

  • Improve Work Flow. Products and services are produced by processes. Improving the way work flows in these processes can reduce costs and improve quality.
  • Eliminate Waste. Waste is any activity or resource in an organization that does not add value to an external customer, such as extra steps in a process or repeating work that has been done by others.
  • Manage Time. An organization can reduce the time to develop new products, waiting times for services, lead times for orders and deliveries, and cycle times for all functions in the organization.
  • Apply Error Proofing. Making mistakes is part of being human. Organizations can reduce errors by redesigning work systems to make it less likely for people to make errors.

These concepts combined with knowledge about your organization can help generate ideas for change.

The box below explains some of the changes made by the caregiver services providers Catalyst Consulting Group is currently coaching. These align with additional change concepts by Associates in Process Improvement.

Change Concepts used by Caregiver Service Providers

  • Develop Operational Definitions. When three organizations collaborated to form one caregiver services program, inconsistencies became evident in the way staff defined different types of client services. An improvement team developed standard definitions for each type of service provided to caregivers. The use of these definitions by staff improved the consistency of services and accuracy of financial coding across locations.
  • Encourage Customers to Use the Service.  An organization had high participation in its caregiver support groups but low utilization of its caregiver coaching services. An improvement team created a checklist for support group participants to self-assess how they might benefit from the coaching service. This tool provided an opportunity for staff to promote coaching to those clients who would gain the most from the service.
  • Use Automation.  A provider had the opportunity to implement a software system used by another part of their organization. They used the system to automate the caregiver services intake process in order to reduce repetitive manual tasks, improve access to information by multiple staff, and collect data to show the impact of their program.

Coming in the next article…

The first two articles in this series helped your organization gain a strong foundation for your improvement efforts by answering the three fundamental improvement questions:

  • “What are we trying to accomplish?” (Aim)
  • “How will we know that a change is an improvement?” (Measures)
  • “What changes can we make that will result in improvement?” (Changes)

The final article in this series will help you test and implement changes using Plan-Do-Study-Act cycles.

 

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