Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is actually being carried out (process measures), and whether any unintended consequences ensue (balancing measures).
Below are some recommended measures to use, as appropriate, to track your progress. In selecting your measures, consider the following:
- Whenever possible, use measures you are already collecting for other programs.
- Evaluate your choice of measures in terms of the usefulness of the final results and the resources required to obtain them; try to maximize the former while minimizing the latter.
- Try to include both process and outcome measures in your measurement scheme.
- You may use different measures or modify the measures described below to make them more appropriate and/or useful to your particular setting. However, be aware that modifying measures may limit the comparability of your results to others.
Posting your measure results within your hospital is a great way to keep your teams motivated and aware of progress. Try to include measures that your team will find meaningful and exciting (IHI, 2011).
For more information on measuring for improvement contact the Canadian Patient Safety Institute Central Measurement Team
- Percentage of patients with type 1 and/or type 2 diabetes with blood glucose below 4.0 mmol/L.
- Percentage of non-diabetic patients with blood glucose below 4.0 mmol/L.
- Percentage of patients with insulin-related medication errors.
Process Improvement Measures
- Percentage of patients assessed for a medical history of diabetes on admission to hospital.
- Percentage of patients with diabetes whose condition is clearly identified on their medical record.
- Percentage of patients with diabetes with appropriate blood glucose monitoring according to their medical status and anti-hyperglycemic agents.
- Percentage of patients with diabetes that are prescribed anti-hyperglycemic medication in accordance with CDA 2013 clinical practice guidelines.
- Percentage of patients that had their insulin adjusted appropriately with the tapering of corticosteroid.
- Percentage of patients undergoing nutrition assessment on admission or during hospital stay.
- Percentage of patients with diabetes receiving hospital nutrition counselling.
- Percentage of patients at risk of hypoglycemia who have ready access to an appropriate source of glucose (oral or IV/glucagon) at all times.
- Percentage of staff that received education regarding glucose (diabetes) management.
- Percentage of patient and/or caregivers who received diabetes education and home management instructions prior to discharge.
- Percentage of patients that had their blood glucose level monitored after starting medications known to cause hypoglycemia.