Measuring Current Performance: Foundation for Improvment and PI CME

June 4, 2010 at 10:46 pm Leave a comment

Current Performance – Measuring the Current Status

This is another in my series of things to consider while engaging in performance improvement or PI CME efforts. This installment addresses our responsibility of understanding current performance. I’ll have a couple of more related to this topic.

We have all heard that every system is perfectly designed to get the results it gets. So, if I want to get different results from the work I do in a system I have to change the system. If I want to change a system to get better outcomes one of the very first things I need to do to is understand the magnitude of any performance problems. This requires an accurate assessment of the work (performance) that is currently going on to produce the outcomes the current system is delivering. To assess performance improvement I absolutely must have a deep understanding of current performance – my baseline against which I measure all progress.

The AMA requirements for Stage A in PI CME include an assessment of current performance measured against acceptable evidenced based guidelines. Where these guidelines exist there are frequently assessment tools one can use to measure current performance against expectations. Where these tools do not exist I have to do the careful work of establishing acceptable standards, developing and testing my data collection instruments, and designing an effective measurement plan. This is frequently true if I am doing an improvement project in my own CME operation.

Just a few points about measuring current performance:
• It is absolutely critical that I get as accurate an assessment of what I intend to measure as possible. Remember – “Garbage in! Garbage out!”
• I need to develop operational definitions that set the boundaries around what is being measured. I need to know what gets counted and what does not. Operational definitions set these boundaries.
• I need to get accurate measurements of performance and outcomes over time. One measurement point in time may not be an accurate reflection of what is actually happening in the setting.
• I need to use valid and reliable measurement instruments even if I have to develop and test them myself.

Careful work in measuring current performance saves an enormous amount of time and effort when it comes to measuring outcomes. I need to do this upfront work very carefully.

Even if I am not working at the performance level in CME but rather at the competence level, I still need a deep understanding of the level of competence of my audience to know where I need to have them move to practice at a different level. Only with this information can I even begin to get an assessment of educational needs versus other needs and barriers that may be precluding them from applying what they know how to do.


Entry filed under: CME, Continuing Medical Education, Improvement, PI CME. Tags: , , , , .

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