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 refer to
Safer Healthcare Now!Delirium Getting Started Kit (Safer Healthcare Now! 2015) for a listing of interventions and associated measures (where applicable) or contact the Canadian Patient Safety Institute Central Measurement Team at
- Per cent of at Risk Patients Who Develop Delirium (IHI Improvement Map, 2012)
Process Improvement Measures
- Percentage of Patients Screened for Delirium (Safer Healthcare Now! Metrics, 2015)
- Percentage of Patients Identified with Delirium (Safer Healthcare Now! Metrics, 2015)
- Per cent of Patients Monitored for Delirium Daily (IHI 2012)
- Per cent of Patients with Delirium Managed by Protocol (IHI 2012)
- Number of Unplanned Extubations per 1000 Mechanical Ventilation Days (Safer Healthcare Now! Metrics, 2015)
- Per cent Compliance with Non-Pharmacologic Strategies (Safer Healthcare Now! Metrics, 2015)
- Early mobility
- Optimize sleep routines
- Daily reassessment of sedation needs, paired with readiness to wean assessment
- Involve family in management of delirium
- Provide need for communication adjuncts
- Reassess restraints daily