Family of measures
What is it?
The family of measures help you to generate your measurement plan. A measurement plan is a deliberate way of collecting information and data. This data is used to track how your system is working and whether your changes are having the impact you want them to be having.
Measurements are broadly broken into three categories and depend on your aim
Outcome: measure whether you have reached your aim. These come from your aim statement and there are usually between 1-3 outcome measures.
Process: measure whether your changes are having the impact you would like them to be having. These can come from your process map, your driver diagram, and your change ideas. There are often between 3-7 process measures.
Balancing: measure potential unintended consequences of your changes. These can come from your process map, your driver diagram, your fishbone diagram, your change ideas or may arise as you begin.
e.g. Aim: By the end of July 2019, reduce the number of hours of work time spent in meetings per week, and increase the percentage of decisions agreed and actioned.
Outcome measures:
Total time in hours spent in meetings,
Total number of actions carried out as a percentage of the total actions agreed
Process measures:
Number of team members attending each meeting,
Meeting duration in minutes
Staff experience:
Staff rating of meeting effectiveness
Balancing measure:
Travel time to/from meetings (test of change – meetings centralised to one location)
e.g. Aim: To save £2000 by January 2020 for my holiday.
Outcome measures:
Amount in savings account
Process measures:
Number of times per week I bring in my lunch
Number of bills changed to cheaper providers
Number of activities I decline due to wanting to save money
Experience:
Personal satisfaction with activities I am doing across the week
Balancing measures:
Cost of groceries
Quality of services received
Number of activities I am doing across the week
Measurements can sometimes move between categories depending on what your aim is. What is important is to collect the data, more than working out whether it is an outcome, process, or balancing measure.
Measures should not be written with a ‘direction’ (i.e. should not include words like increase or decrease). Measures are observations of what is happening. The ‘direction’ words should be saved for your aim or change ideas.
For all measurements it is important to get a baseline before you start to implement changes. If you don’t understand your system before you make changes then you can’t understand the impact of the changes on them.
Why use it?
Here we are considering data for improvement, not for research. There are a number of reasons why a measurement plan is important:
Without it, you are unlikely to have evidence of the impact of your changes
Data and measurement can be motivating for people who aren’t that enthusiastic or are sceptical about what you’re doing. Similarly, it can be motivating for enthusiasts who need an extra push.
Data allows you to see whether what you’re doing is worth it or whether you’re just implementing change for change sake.
How to use it?
There are many tips and suggestions for how best to define, collect and analyse measures. A good place to start is here.
Always talk to your team, you may be surprised at what data they already have access to, what they can collect and what they may be willing to measure.
Example Measurement Plan
More information
Quality Improvement Zone NES – click for further information and templates.
IHI – click for additional information and examples.
NHS Improvement – click for more information.