Designing Effective Clinical Measurement: Recognizing and Correcting Common Problems

Brent James, MD, MStat - Clinical Professor, Department of Medicine, Stanford University School of Medicine; Senior Advisor, Health Catalyst Dr. W. Edwards Deming, the father of quality improvement theory, famously (and routinely) noted that “aim defines the system.” That is especially true for clinical measurement. This session will examine a series of principles that underlie effective clinical measurement. It will start with the idea of “transparency” as defined by the Institute of Medicine, and discuss how different functional levels within which transparency plays a critical role for healthcare delivery organizations. The presentation will address proven methods to select appropriate subsets of measures, among a functional infinity of possible metrics. Dr. Brent James will also discuss how the idea of signal versus noise levels in clinical measurement, including methods to assess and mitigate noise (technically, “gauge theory” and Measurement System Evaluation). These concepts will be brought together in the form of nested measurement systems, where data is captured in real-time at the front line then “rolls up” through an organization (nested dashboards). This, in turn, will support “drill down” activities that can track findings in higher order reports back down to actual work execution. The course is intended for people who already have highly developed measurement and analysis skills and experience.

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