Information for System Improvement


     All system participants have a role to play in ongoing system improvement. Participants include not only providers and their immediate managers, but also system clients, all management levels and policy makers whose job it is to act centrally on behalf of system clients.

     Some participants, mostly providers, believe that they have better system information because they work with many clients. Other participants, mostly managers, think they have better information because they work with many providers. Administrators and policy makers think that they have the best systems information because they have the obligation to review systems performance as central part of their job descriptions. System clients are not viewed by other participants as having valuable information on system performance although they do. All these players are like the blind men and the elephant: they all touch different parts of the beast and therefore draw widely differing conclusions about what they are experiencing.

     For system participants to truly share the responsibilities for ongoing system improvement, they need to share information. Combining information from all participant perspectives is the best hope of accurately describing the elephant, what it is doing and where it is going.

     It is not in the skill sets of most system participants to do this information compilation accurately, with enough breath to be meaningful and with enough currency to be actionable. In order to initiate and sustain improvement efforts system participants need ongoing data support. That means access to relevant data streams reporting on all inputs, outputs, variations, costs and outcomes across clients, providers, managers, organizations and for the system as a whole. Data aggregation, integration and display must be appropriate to participant needs and interests: compilations for clients will not be the same as compilations made available to other participants. Providers, managers, administrators and policy makers will each have different information needs.

     Although the compilations will look different across participants it is important that everyone has access to all the data all the time. We can't get better unless we agree to focus our energies. We are unlikely to agree on improvement priorities without reference to the same performance indicators. Those shared indicators will signal root causes which will specify who has to be involved in creating potential solutions. Those same indicators will tell us what countermeasures are effective over what time and resource cost. We need the data; we need it in comprehensible formats and we need it all the time.

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