Achieving your dreams: Part 2 – Focusing your attention

Achieving your dreams: Part 2 – Focusing your attention

To continue in our series on achieving our dreams, the first step is to spend time clarifying your dreams, putting them in writing, and communicating them to key stakeholders.

The next step is to focus your attention on, and measuring the key items that will help you achieve this dream.  There are 2 kinds of measures: Lag Measures and Lead Measures.

Lag measures are big retrospective measurements like quarterly earnings, monthly home sales volumes, customer satisfaction, and quality scores. While lag measures are very important, by the time they are received, it is too late to impact them.

Lead measures are those critical measures where you can have direct and real-time influence. These are predictors of success on your lag measures. Lead measures can often be more difficult to capture as the data may not be readily available, and may require development of manual capture mechanisms.

For example, your goal may be to reduce preventable harms to patient in your hospital from 2.0 per 1000 patient days (current state) to .25 (future state) by June 2018 (time specific).  Your lag measure may be to reduce patient falls.  If you are using patient falls as your measure, once a patient has fallen, it is too late to have an impact (at least for that particular fall).  Therefore, we need to focus our attention on the lead measures.  Examples of lead measures might be: falls risk assessments completed, use of bed alarms, intentional rounding on each patient every hour, use of non-skid socks. use of “falls risk” colored gowns, use of assisted ambulation, toileting within arm’s reach of a nursing staff member.  Adherence to these measures is a predictor of reduced falls.

Movement on lead measures is a predictor of movement on lag measure, so we need to focus our attention on the lead measures.

Key to success: In order to increase ownership, it is critical to have the team develop their own lead measure.

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