Measure Up reader, Kenneth, works in a hospital and has this measurement challenge: “Different people want to follow up on different things. The nurses, for example, think it is crucial to follow up on how many phone calls they answer. I reckon it is because they want evidence to show management how they spend their time at work. But I do not think this is a critical KPI or success factor for our hospital. How do I draw the line? Do I need to draw the line? How can you get all people to accept this? The bigger question here might be: Who should have access to KPIs?”

Let’s start with an answer to Kenneth’s last question: Everyone should have access to KPIs. Everyone needs feedback on how well their efforts and collaborations are getting the intended results, and contributing to the hospital’s strategic direction.

But this isn’t the first challenge that Ken should tackle. If he were to go ahead and champion an effort to support everyone in getting performance measures they can use now, he’d likely create a quagmire of useless information and nurture a culture of defensiveness.

People would be creating measures of their activity and workload, not measures of their results. They would be using measures as a tool to defend their thus-far ignored complaints, rather than as a tool to improve their processes and results.

The clue is in Ken’s suspicions about why nurses want to measure the number of phone calls they answer. This is an activity measure, not a performance measure. It’s about actions, not results. And it is likely that nurses want to send a message to management that their time is being wasted on tasks that aren’t supporting what they know are the important results; namely patient care.

This is where Ken should start. On the important results. When an organisation can articulate it’s strategic results clearly, it can create a cause-effect cascade of results that reach right down to the processes that nurses work in.

These results are the things to be measured. The hospital might have a strategic result of reducing the length of stay of patients in the hospital. This might cascade to the processes that nurses work in, giving them a result of patient recovery speed. That would be one of their contributions to the hospital’s strategy.

Then in analysing how best to reduce patient recovery time, nurses might identify that administrative tasks (like answering phone calls) are consuming too much time. This cause-effect link to strategically important results would give nurses a powerful case for a process improvement initiative to streamline the most cumbersome of their administrative processes.

Measuring the number of phone calls they need to answer (among other admin tasks) is therefore a diagnostic measure, not a performance measure.

Results are at the heart of good performance measures; clear, specific, measurable results that come from strategic thinking. So Kenneth, build that results map before you worry about who should measure what. Measures are born from clear, specific, measurable results.

DISCUSSION:

What advice would you offer to Ken, to help him reach the outcome of people measuring what really matters?