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Measurement is a critical part of testing and implementing changes; measures tell a team whether the changes they are making actually lead to improvement.

Measures for Operational and Clinical Improvement in the Emergency Department

These measures were developed as part of IHI's Learning and Innovation Community on Operational and Clinical Improvement in the Emergency Department and are useful for teams improving operational flow in the Emergency Department.

Hospital Flow Measurement Guide

A measurement framework for measuring hospital flow/throughput across the system.

Third Next Available Appointment

Average length of time in days between the day a patient makes a request for an appointment with a physician and the third available appointment for a new patient physical, routine exam, or return visit exam.

Incidence of Severe Hypoglycemic Episodes

The aim is to achieve glucose control less than 180 mg/dl in 100 percent of critically ill patients without increased incidence of severe hypoglycemia

Ventilator Bundle Compliance

Compliance with the Ventilator Bundle is defined as the percentage of intensive care patients on mechanical ventilation for whom all four of the elements of the Ventilator Bundle are documented on daily goals sheets and/or elsewhere in the medical record.

Ventilator-Associated Pneumonia (VAP) Rate per 1,000 Ventilator Days

Ventilator-associated pneumonia (VAP) is defined as pneumonia in a patient intubated and ventilated at the time of or within 48 hours before the onset of the event. (There is no minimum period of time that the ventilator must be in place in order for the pneumonia to be considered ventilator-associated.) The VAP rate is defined as the number of ventilator-associated pneumonias per 1,000 ventilator days

Improving Perinatal Care Measurement Strategy

IHI's evolving strategy for measuring the safety of perinatal care, reducing harm, and supporting more patient- and family-centered care.

Percent of Surgical Cases with Appropriate Selection of Prophylactic Antibiotic

Percent of surgical patients receiving prophylactic antibiotic consistent with adopted guidelines.

Percent of Clean Surgery Patients with Surgical Infection

Care teams seeking to prevent surgical site infection are encouraged to collect data on this outcome measure and other measures recommended in the How-to Guide: Prevent Surgical Site Infection.

Percent of Surgical Cases with On-time Prophylactic Antibiotic Administration

Antibiotic started means administration has begun but is not necessarily completed Cases in which time of antibiotic administration or time of surgical incision is not documented should be excluded from the numerator and denominator Exceptions.

Volume of Surgical Workload per Month

Surgery is defined as involving an incision and occurring in an operating room.

Percent of Surgical Patients Who Received Prophylactic Antibiotics After Antibiotics Were Discontinued within 24 Hours of Surgery

Formula: The number of patients receiving prophylactic antibiotics who had them discontinued within 24 hours divided by the number of patients who received prophylactic antibiotics.

Percent of Patients with Appropriate Hair Removal

Formula: The number of surgical patients with hair removed appropriately divided by the number of patients requiring hair removal.

Percent of Major Cardiac Surgical Patients with Postoperative Glucose Control

Use the measure developed by the Surgical Care Infection Program (SCIP).

Percent of Colorectal Surgical Patients with Normothermia in PACU

Use the measure developed by the Surgical Care Improvement Project (SCIP).

Measures to Prevent Healthcare-Associated Infections

It is important to track three types of measures when you are working to reduce healthcare-associated infections (HAIs).

Cost per Surgery

Formula: Dollars allocated to surgical accounting codes per month divided by the number of surgical cases.

Number of Days Between Surgical Site Infections (SSIs)

Infections acquired post-operatively by a surgical patient at the surgical site.

Registry Size

The total number of patients in the registry — an information system that can track individual patients as well as populations of patients.

Measures: Deploy Rapid Response Teams

Care teams should measure key components of deploying Rapid Response Teams recommended in the How-to Guide: Deploy Rapid Response Teams.

Measures: Prevent Harm from High-Alert Medications

Care teams should measure each of the key interventions recommended in the How-to Guide: Prevent Harm from High-Alert Medications.

Measures: Prevent Pressure Ulcers

Care teams should measure compliance with each of the key components of evidence-based pressure ulcer care recommended in the How-to Guide: Prevent Pressure Ulcers.

Measures: Prevent Central Line Infection

Care teams should measure each of the evidence-based interventions recommended by the How-to Guide: Prevent Central Line Infection.

Measures: Prevent Adverse Drug Events (Medication Reconciliation)

Care teams should measure each of the evidence-based interventions for preventing adverse drug events using medication reconciliation recommended in the How-to Guide: Prevent Adverse Drug Events (Medication Reconciliation).