AMSA: Patient Safety: IHI QI 103
Testing and Measuring Changes with
PDSA Cycles Questions and Correct
Answers.
Use the following scenario to answer the first two questions:
You volunteer at a student-run clinic associated with your academic health center. As a member
of the student board, you are constantly looking for ways to improve the clinic. One common
complaint is that it takes too long to check patients in once they arrive, and you decide to tackle
this problem.
Which of the following might be an outcome measure for this effort?
(A) Average number of minutes between patient arrival at the clinic and completion of check-in
(B) Number of patients seen by the clinic
(C) Average number of students helping to check a patient in
(D) None of the above - Answer A
Outcome measures tell you how the system is performing. In this case, the aim of the project is
to decrease the time it takes to check in patients, so an appropriate outcome measure for this
project could be "average number of minutes between patient arrival at the clinic and
completion of check-in." The average number of patients seen by the clinic and the average
number of students helping to check in patients might be useful to track as balancing and
process measures, respectively.
Which of the following is the best way to collect baseline data for this improvement project?
(A) Look at a few patients every day for a week.
(B) Look at 10 percent of patients for a year.
(C) Look at 100 percent of patients for a month.
(D) There is no reason to collect baseline data. - Answer A
The best answer is to use a small sample and gather the data quickly. When measuring for
improvement, it's often unnecessary (and may defeat the goal of rapid, iterative testing) to
collect all available information over an extended period of time. Baseline data is important for
knowing whether changes you are making are, in fact, leading to improvement.
, Which of the following is an example of an effective measurement technique for improvement?
(A) Always strive for perfection.
(B) Use quantitative and qualitative data.
(C) Always set aside designated time for data collection.
(D) All of the above - Answer B
The best answer is to use qualitative and quantitative data. Qualitative data, which is not so
much about numbers as it is about the depth of the information collected, can be a rich source
of knowledge in improvement projects. Interviews or focus groups are common sources of
qualitative data. Measurement is not the goal; improvement is the goal. In order to move
forward to the next step, a team needs just enough data to know whether changes are leading
to improvement. ("Seek usefulness, not perfection" is a mantra at IHI.) To save time, integrate
data collection into the daily routine as much as possible.
Why should you consider collecting a family of measures when undertaking an improvement?
(A) It makes the project more publishable.
(B) A single measure may not be enough to determine the impact of a change on the system.
(C) All improvement projects are so complex that they require multiple measures.
(D) All of the above - Answer B
Health care systems are extremely complex. A small change in a complex system can lead to
many unexpected results, so using only one measure may not capture the effect of the change
upon the system. Using more measures will not necessarily increase the likelihood of
publication. Finally, it is health care that is complex, not necessarily the improvement project
itself. The most successful projects are often the simplest ones.
You're working on an improvement project at a community mental health center. Your project
aim: "Within two months, 100 percent of our patients will wait less than 30 minutes to be seen
by a physician." You decide to gather data on patient wait times over a week-long period in
order to establish a baseline. What might be an important consideration as you plan your data
collection strategy?
(A) Whether you'll provide food for the patients who wait more than 30 minutes.
(B) What exactly you mean by "wait less than 30 minutes to be seen" — does this include the
time the patient spends checking in, for instance?
(C) How to establish consensus among the clinic's caregivers about the value of the project
before gathering data.
Testing and Measuring Changes with
PDSA Cycles Questions and Correct
Answers.
Use the following scenario to answer the first two questions:
You volunteer at a student-run clinic associated with your academic health center. As a member
of the student board, you are constantly looking for ways to improve the clinic. One common
complaint is that it takes too long to check patients in once they arrive, and you decide to tackle
this problem.
Which of the following might be an outcome measure for this effort?
(A) Average number of minutes between patient arrival at the clinic and completion of check-in
(B) Number of patients seen by the clinic
(C) Average number of students helping to check a patient in
(D) None of the above - Answer A
Outcome measures tell you how the system is performing. In this case, the aim of the project is
to decrease the time it takes to check in patients, so an appropriate outcome measure for this
project could be "average number of minutes between patient arrival at the clinic and
completion of check-in." The average number of patients seen by the clinic and the average
number of students helping to check in patients might be useful to track as balancing and
process measures, respectively.
Which of the following is the best way to collect baseline data for this improvement project?
(A) Look at a few patients every day for a week.
(B) Look at 10 percent of patients for a year.
(C) Look at 100 percent of patients for a month.
(D) There is no reason to collect baseline data. - Answer A
The best answer is to use a small sample and gather the data quickly. When measuring for
improvement, it's often unnecessary (and may defeat the goal of rapid, iterative testing) to
collect all available information over an extended period of time. Baseline data is important for
knowing whether changes you are making are, in fact, leading to improvement.
, Which of the following is an example of an effective measurement technique for improvement?
(A) Always strive for perfection.
(B) Use quantitative and qualitative data.
(C) Always set aside designated time for data collection.
(D) All of the above - Answer B
The best answer is to use qualitative and quantitative data. Qualitative data, which is not so
much about numbers as it is about the depth of the information collected, can be a rich source
of knowledge in improvement projects. Interviews or focus groups are common sources of
qualitative data. Measurement is not the goal; improvement is the goal. In order to move
forward to the next step, a team needs just enough data to know whether changes are leading
to improvement. ("Seek usefulness, not perfection" is a mantra at IHI.) To save time, integrate
data collection into the daily routine as much as possible.
Why should you consider collecting a family of measures when undertaking an improvement?
(A) It makes the project more publishable.
(B) A single measure may not be enough to determine the impact of a change on the system.
(C) All improvement projects are so complex that they require multiple measures.
(D) All of the above - Answer B
Health care systems are extremely complex. A small change in a complex system can lead to
many unexpected results, so using only one measure may not capture the effect of the change
upon the system. Using more measures will not necessarily increase the likelihood of
publication. Finally, it is health care that is complex, not necessarily the improvement project
itself. The most successful projects are often the simplest ones.
You're working on an improvement project at a community mental health center. Your project
aim: "Within two months, 100 percent of our patients will wait less than 30 minutes to be seen
by a physician." You decide to gather data on patient wait times over a week-long period in
order to establish a baseline. What might be an important consideration as you plan your data
collection strategy?
(A) Whether you'll provide food for the patients who wait more than 30 minutes.
(B) What exactly you mean by "wait less than 30 minutes to be seen" — does this include the
time the patient spends checking in, for instance?
(C) How to establish consensus among the clinic's caregivers about the value of the project
before gathering data.
