data for learning and improvement david m. williams, ph.d. institute for healthcare improvement

Data for Learning and ImprovementDavid M. Williams, Ph.D.

Institute for Healthcare Improvement

Murder rate down compared to this

time last year.

Celebration

Despair

Three Considerations

• Data Definition• Date Collection• Data Display

Data Definition

% child receiving assessments

Wait times

% of mom’s receiving pre-natal vitamins

% children in one clinic receiving assessment

# of books read% of meals with veg

Number of double smiles

PDSAs per week% parents rating 7 or greater for confidence

% of Mom’s screened for unhealthy habits

# of huddles per week

% Team members rate promise level

Data Definition

How will you know a change is an improvement?

Count =

Percentage = Rate =

Count

CountTotal 100

CountTotal Pop

100,000 population

Data Collection

Safety Cross

Case Study

Data Display

Elements of a Run Chart

Se-ries1

160

180

200

220

240

260

280

300

320

LO

S (m

inut

es)

2/16/11 3/16 4/13 5/11 6/8

Week

Mea

sure

Time

X (CL)~

The centerline (CL) on a Run Chart is the Median

IG p.435

Low Tech – Hand Written – Tester Owned

% antenatal bookers eligible for Healthy Start in Leith (self report)(n=410; source Maternity Trak)

Monthly data

release

Monthly data

release

Leith Pioneer site work

started 3 March

Universal enquiry re HSComplete form

at booking appt

Team meeting

Leith Survey Monkey

Team meeting

and survey results

Focus on Trak docu-mentation

“Shift” on run chart (6+ points above median)

Median

Annotated

Change Made Between Weeks 7 & 8

Before Change (Measure on Week 4) After Change (Meaure on Week 11)0

1

2

3

4

5

6

7

8

9

8

3

Del

ay t

ime

(ho

urs

)

Case 1

1 2 3 4 5 6 7 8 9 10 11 12 13 140

1

2

3

4

5

6

7

8

9

10

Weeks

Del

ay t

ime

(ho

urs

)

Ch

ang

e

Case 2

1 2 3 4 5 6 7 8 9 10 11 12 13 140

1

2

3

4

5

6

7

8

9

10

Weeks

Del

ay t

ime

(ho

urs

)

Ch

ang

e

Case 3

1 2 3 4 5 6 7 8 9 10 11 12 13 140

1

2

3

4

5

6

7

8

9

10

Weeks

Del

ay t

me

(ho

urs

)

Ch

ang

e

Case 4

1 2 3 4 5 6 7 8 9 10 11 12 13 140

1

2

3

4

5

6

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8

9

10

Weeks

Del

ay t

ime

(ho

urs

)

Ch

ang

e

Case 5

1 2 3 4 5 6 7 8 9 10 11 12 13 140

1

2

3

4

5

6

7

8

9

Weeks

Del

ay t

ime

(ho

urs

)

Ch

ang

e

Case 6

1 2 3 4 5 6 7 8 9 10 11 12 13 140

1

2

3

4

5

6

7

8

9

10

Weeks

Del

ay t

ime

(ho

urs

)

Ch

ang

e

Change Made Between Weeks 7 & 8

Before Change (Measure on Week 4) After Change (Meaure on Week 11)0

1

2

3

4

5

6

7

8

9

8

3

Del

ay t

ime

(ho

urs

)

Radar or Spider Diagram

Radar or Spider Diagram

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4

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8

10

1 2 3 4 5 6 7 8 9 10 11 12 13 14

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10

1 2 3 4 5 6 7 8 9 10 11 12 13 14

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10

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10

Aggregate vs. Stratified

Chinese Restaurant Demand Collection

Monday Tuesday Wednesday Thursday Friday0

5

10

15

20

25

30

Tables per Day

Lunch

Dinner

Monday Tuesday Wednesday Thursday Friday0

5

10

15

20

25

30

Tables per day - Lunch

Monday Tuesday Wednesday Thursday Friday0

5

10

15

20

25

30

Tables per day - Dinner

Breaking Down Data

Final 2 Slides

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# of Run Charts per Storyboard

CPP Storyboards

# o

f P

DS

A C

har

ts

Case Study – Improvers in action

https://www.youtube.com/watch?v=iWYIWE7SKcM