NIATx –How Do We Know A Change Is An Improvement? a.k.a. “Data Is Your Friend”-REMIX-Graphs and Graphing

Thomas R Zastowny, PhDNIATx Coach & Healthcare Consultant

Reduce Waiting & No-Shows Increase Admissions & Continuation All authors share equally in this presentation

“To put it simply: tell your story clearly and communicate the data accurately. Do that, and you'll be

alright….”

Basic Rules for Making Charts Right « graphs-of-the-day.com. Pingback: Curious Cat Management Improvement Blogflowingdata.com/2010/.../7-basic-rules-for-making-charts-and-graphs/ -

1. Check the data2. Label axes3. Include units4. Keep your geometry in

check5. Include your sources6. Explain encodings7. Consider your audience

                                     

Model for Improvement

Act Plan

Study Do

• What are we trying to accomplish?• How will we know that a change is an improvement?• What changes can we make that will result in an improvement?

Reference: Langley, Nolan, Nolan, Norman, & Provost. The Improvement Guide

Hunches Theories

Ideas

Changes That

Result in Improveme

nt

A P

S D

APS

D

A P

S DD S

P ADATA

Change Cycles

Three common pictures:

■Pie Charts

■Bar Graphs

■Pictograms

SAMPLE BAR

Leadership Characteristics

0% 10% 20% 30% 40% 50%

Focuses team on objectives.

Is respected

Is persistent

Results verifiable by data

Challenges status quo

Top Five Mentions - Overall

Change Leader Characteristic Survey29 Categories, 99 responses - Change leaders (n = 40)/Executive sponsors (n=20)/Change teams members (n=39)

STAR-SI Results: Improvements on a Single Measure

RMHA: Decreased average days from 1st request to admission by 47% (on average) for 12 months

FACTS: Almost doubled the % of first appointments kept on average (38% to 71%)

HHC: Reduced the average # of days from 1st Assess to Admission by 39% (on average) for 15 months

SE Nassau: Increased the number of assessments per month by 30% (on average)

29

23

39

29

0

5

10

15

20

25

30

35

40

45

Average Assessments permonth

Average Admissions permonth

Baseline

April/May 2008

STAR-SI providers* increase monthly assessments by 34 % and monthly admissions by 26%

*n = 8 STAR-SI Providers (Year I and II)

Sample STAR-QI ReportAS4: # Days from 1st request for service to 1stclinical service

This provider was able to reduce the # days from the time of 1st contact to first service by almost 4 days.

Example ChartTime from First Contact to First Treatment

0.00

2.00

4.00

6.00

8.00

10.00

12.00

Jun-03

Jul-03

Aug-03

Sep-03

Oct-03

Nov-03

Dec-03

Jan-04

Feb-04

Mar-04

Apr-04

May-04

Jun-04

Jul-04

Aug-04

Sep-04

Oct-04

Nov-04

Changes Implemented ChangesSustained

PI TEA –Use of Data (NIATx Workbook, 2007)

Summary-10 Questions1. Does the message of interest stand out clearly?

2. Is the purpose or title of the picture evident?

3. Is a source given for the data, either with the

picture or in an accompanying article?

4. Did the information in the picture come from a

reliable, believable source?

5. Is everything clearly labeled, leaving no

ambiguity?

Summary-10 Questions6. Do the axes start at zero or not?

7. Do the axes maintain a constant scale?

8. Are there any breaks in the numbers on the

axes that may be easy to miss?

9. For financial data, have the numbers been

adjusted?

10. Is there information cluttering the picture or

misleading the eye?