If the CEO of your facility asks you how the safe patient handling (SPH) system is working will you be able to tell him/her? Do you know if it is effective and meeting its purpose and goals? Would you provide the CEO anecdotal answers by stating what you hear from staff? Or, would you be able to provide meaningful, objective data that supports the effectiveness of the program? In order to know that SPH is successful and effective, you need to have objective measures in place that allow you to accurately assess the program.
One common weakness in safe patient handling systems is the lack of meaningful and accurate measurements that assess their effectiveness. Before we discuss metrics specific to SPH, we need to first define and understand the purpose of metrics.
Definition of Performance Metrics
According to Webster’s Dictionary, the definition of a metric is a standard definition of any measurable quantity. The types of metrics we are interested in are performance metrics (PM). Performance metrics is a standard definition of a measurable quantity that indicates some aspect of performance.
A common acronym for performance metrics is SMART. SMART stands for:
- “Specific”: Specific and targeted to the area you are measuring
- “Measurable”: You can collect data that is accurate and measurable
- “Actionable”: Easy to understand, and it is clear when you chart the performance over time which direction is “good” and which is “bad,” so you know to take action
- “Relevant”: Don’t measure things that aren’t important
- “Timely”: Data can be collected when you need it, not delayed
One cannot have a PM without having a performance objective and a performance goal associated with it. A performance objective (PO) is a general statement of the desired achievement and a performance goal (PG) is a specific statement of the desired level of achievement.
For example, a SPH performance objective might be to reduce the number of lost work days associated with patient handling injuries. The performance goal would be lost work days associated with patient handling injuries < 10/year. The performance metric then would be the actual number of lost work days for that year.
PMs can also be leading, lagging, or concurrent indicators. Leading indicators predict the future. Lagging indicators measure past performance. Concurrent indicators measure performance in real time. In the example above, the number of lost work days related to patient handling injuries is a lagging indicator.
Purpose of Performance Metrics in SPH
The purpose of metrics is to allow the SPH system to be evaluated to see if it is meeting the needs of its customers and objectives. Metrics should show the strengths and weaknesses of the system. They are a necessary component of continuous improvement processes of the SPH system. Without metrics, areas of weakness will not be identified until they have grown to become unavoidable large issues. Fixing problems early on is much preferred and easier done compared to large, systemic problems. Besides being a system monitor, metrics also provide the basis for SPH justification to senior leadership/administration.
We now have to consider who determines what PMs are meaningful and who is responsible for collecting, analyzing, and reporting the data. It is this author’s recommendation that PMs are determined and approved by members of the SPH committee. This allows for each PM to be discussed and evaluated for accuracy and meaningfulness by everyone on the committee. This process should avoid the selection of inappropriate PMs. Most likely the SPH coordinator will be the person who analyzes and reports the data. This doesn’t mean that the coordinator will be the only one collecting the data. If there is a PM related to the number of slings laundered per week, which data would be collected by the person responsible for that task, who would then send the data to the coordinator.
SPH Performance Metrics
There should be one or more SPH performance metrics for each area or topic addressed by the SPH system. Some examples of areas to consider establishing PMs are in regard to staff, patients, managers/supervisors, administration, supporting departments, and the SPH committee. For each defined area, you then need to determine what topic/task is meaningful to measure and can provide accurate data. The example that was used earlier would fall under staff safety. You could have other staff safety PMs. Or you could add another PM that relates to a different staff topic; i.e., staff training.
Here is an example of using ongoing (after SPH implementation) staff training as a basis for PM:
PO: All direct patient care providers have demonstrated SPH hands-on competency annually
PG: 100% of direct patient care providers completed annual SPH hands-on competency annually
PM: % of direct patient care providers who completed annual SPH competency
Another example of a PM related to the SPH committee’s performance/engagement is the percentage of attendance at each meeting:
PO: High level of attendance for each SPH committee meeting
PG: 80% of members attend each SPH meeting
PM: Actual percentage of members that attend each SPH meeting
There are numerous possible performance metrics for SPH, too many to include in this article. A SPH system that includes performance objectives, goals, and metrics will reap the benefits in having them as they are vital for monitoring, improving and justifying the SPH system.
If you want to learn more about SPH metrics or want to learn more about how to design, implement, and sustain SPH for long term success, please contact Ergo-PATH System, LLC at firstname.lastname@example.org or visit our website, www.ergo-pathsystem.com. There are only two SPH System Success seminars left for 2010: August 18-20 in Minneapolis and September 15-17 in New Orleans. Sign up online now! Space is limited. Want to save on travel and have all of your SPH committee trained? If yes, contact us as we’d be happy to come to you.