1. Section Editor(s): Raso, Rosanne MS, RN, NEA-BC

Article Content

You can't manage it. You've heard this over and over again. Do you feel like your performance has boiled down to a report card and what's not there isn't important? On the flip side, there's value in what we can't measure. And, sometimes, there's no value in what we do measure. Let's not forget the rest of your work that may not be reflected on your report card.

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Don't get me wrong. Attentiveness to key performance indicators and measures of success are critical. Using quantifiable goals for program evaluation and performance improvement is fundamental. Our transparent and quality-driven healthcare world insists on it, and should. We identify targets, monitor progress, and make improvements based on data. How else do we know if we've been successful and what issues need to be addressed? Demonstrating empirical outcomes is an essential Magnet(R) component and makes sense to prove nursing excellence. In Value-Based Purchasing, meaningful use, and other value-based care programs, performance metrics are king. If you can't measure it, you can't get rewarded or punished, or be compared or benchmarked.


This leads us to that palpable sense of dread when your performance metrics are about to be revealed. That click to open the report may involve breath holding or even prayer. It's reminiscent of grade school report cards and standardized test scores. In the education world, there's also controversy over excessive measurement, its fairness, resultant rigid curricula, and whether we're missing out on the value of what we can't quantify, such as a student's moral character, inquisitiveness, or love of learning.


Isn't it the same for us? Aren't there important unmeasurable components, such as the positive energy of our team or the emerging confidence of a new nurse, which you know are translating into better patient care? What about the grateful family who doesn't complete a satisfaction survey or all of the relationship building you're doing? You feel these things, you don't measure them.


To make it even worse, we often measure insignificant things just to have a metric. Or maybe we focus on the process measure that looks good even though it isn't as meaningful as the outcomes, which don't look as good. Or we make up definitions and then have apples and oranges that shouldn't be compared. Of course, this is all done with good intentions to prove our measured performance. On the other hand, our governmental, regulatory, and national database measures are defined in excruciating detail. Then we have apples to apples and plenty of opportunities to design foolproof documentation to meet expectations. Too bad documentation and actual practice aren't as clinically related as we would like and we're forced to be evaluated by our keystrokes.


Knowing how to turn data into information adds another dimension to the measurement adage-if you can't understand or use the data, it doesn't help you manage either. Drilling into data to find meaning and focus is illustrative and even fun. After a metric has no meaning to your practice or is of questionable integrity, stop measuring it unless it's obligatory-a situation we face all too often. Two articles in this issue will help you find meaning in data: "Measures That Matter" on page 14 and "Metrics for Nurse Managers" on page 30.


So if you can't measure it, it may still be valuable. Use both quantified and unquantified results to evaluate yourself and your team. Your report card is significant and guides your priorities, but it isn't the whole story.



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