What we measure, we improve. We all “know” this to be true.
So, why is it that so many healthcare quality programs fail to improve performance year after year?
Why aren’t we taking our value-based purchasing contracts to the bank?
I’ve given this a lot of thought over the years, watching quality programs stall or make progress under a passionate leader only to regress when that person moves on.
We’re measuring, but we’re not improving. Why?
We don’t know what we’re measuring.
Picture this: it’s a sunny Tuesday afternoon, and you’ve somehow squeezed in your annual physical between work obligations and carting the kids to activities. You’re expecting a quick appointment and a clean bill of health until your provider says the words you’ve been hoping to avoid:
“It looks like you’ve gained a few pounds since I last saw you…”
By the end of the visit, you’ve agreed to keep a food diary. You download an app and start logging your calories and exercise. Pretty soon, you’re skipping the afternoon candy bar, taking the stairs, and watching your numbers improve.
It’s simple: you measured it, and it improved.
But here’s the difference: when you’re tracking calories, you know what you’re measuring, and you know exactly how to impact it. You get real-time feedback. The goal is clear, the outcome is visible, and the data is personal.
In healthcare quality, that’s not how it works.
Take a standard quality measure like diabetes poor control (HbA1c >9%).
It sounds simple enough. We’re measuring the rate of patients whose diabetes is poorly controlled. To make it slightly trickier, it’s an inverse measure, meaning lower rates are better.
But then you open the measure specs and suddenly you’re knee-deep in a three-page document outlining criteria for the denominator, numerator, exclusions, and qualifying visits.
If you’re already lost, you’re not alone. For many teams, half the battle is simply understanding what the measure actually means.
We don’t know how to measure it.
Okay, now you’ve got it figured out. You understand the measure specs and you’ve managed to pull a report from your EHR. You take your shiny new report to a provider meeting and show that 65% of your diabetic patients are “poorly controlled.”
There’s a stunned silence. Then someone erupts:
“These numbers are wrong. That’s not my data!”
You soon discover that your EHR doesn’t interface with the lab most of your patients use.
The system is technically reporting “correctly,” but it’s missing half the data.
Cue the process meetings, stakeholder calls, and testing cycles to fix it.
Okay! So, now you understand the measure and you have accurate data. You type up your meeting minutes and your documentation workflows and now you’re ready to improve!
But your next quarterly report looks the same.
We don’t know when to measure it.
Here’s the problem: you might understand the measure, and now you have data, but you’re not really measuring it in a way that drives change.
If your data cycle is quarterly, you’re grading your team months after the behaviors that impacted the score.
If you won’t know the impact of your afternoon candy bar for three months, how motivated are you to skip it today?
Providers need real-time, actionable data before they walk into the exam room.
We don’t know why it matters.
Healthcare quality data can feel abstract, even punitive.
Walk into most healthcare organizations and you’ll find staff and providers who don’t know what’s being measured or why. They see endless reports, alerts, and asks, but no clear connection to patient care or financial health.
Teams need to understand both the clinical and the financial reasons a measure matters.
What poor outcomes are we preventing when diabetes is controlled?
How does this impact the organization’s financial sustainability? (How does it impact the next COLA?)
Measuring in a meaningful way.
If we want to turn measurement into improvement, we have to bridge the gap between knowing and doing.
Here’s where to start:
- Measure what matters.
Choose fewer, clearer metrics. Make sure everyone (from the receptionist scrubbing the schedule to the provider documenting the visit) understands what success looks like.
- Make it real-time.
Build systems for chart scrubbing or daily dashboards so data informs care before it’s too late to change it.
- Close the loop.
Review data in frequent team huddles, not just quarterly meetings. Discuss barriers, celebrate wins, and adjust workflows in real time.
- Connect data to meaning.
Show the link between performance, patient outcomes, and financial health. Make the “why” clear.
- Maintain momentum.
Improvement isn’t an event, it’s a habit. Make measurement part of daily operations, not a yearly ritual.
Interested in what we can do for your organization? Contact us to learn more or book a free consultation using Calendly.