As part of establishing the vision for what the ideal service looks like and the objectives required to deliver it, the project team will have identified information or data that will be needed to measure the improvement.

This stage will involve selecting a range of measures that will demonstrate improvement against the agreed objectives.  This will also require a discussion around the expectations of the impact of the service improvement.  A process for monitoring service improvement will also need to be considered.

Selecting appropriate measures will be dependent upon the area of service that is being looked at for improvement.  They should ideally capture outcomes measures for patients for health, wellbeing and experience, however process measures, are often equally applicable where an improvement to a process or part of a pathway is being considered.

The working group may also wish to consider any unintentional effects of the changes and how these can be measured.  This is particularly relevant if one area of a pathway is being reviewed and may have a knock-on effect on another part of the pathway.

Having set the improvement strategy through setting the vision, the objectives and the measures, the detailed improvement work can be initiated.  This work can involve using a range of tools and links to support you as you work through a six-point improvement cycle to:

• Identify improvement solutions
  
• Plan your actions
  
• Try out the actions
  
• Evaluate the results from the actions
  
• Modify the actions
  

• Implement and spread the amended approach

Measures – Checklist

Use available data to establish current
performance or experience

Establish the baseline data

Develop a practical reliable data
collection method

Decide an appropriate frequency and
timescale

Consider sampling techniques

Monitor and review

Resources you will find useful here are:

• NHS Diabetes Information service tools
  
• NHS Diabetes Patient Survey tool