How to Measure the Hardest Things to Measure

by Stacey Barr

The hard things to measure are often the most important things to measure. How can we solve this gridlock?

The hard and important things to measure include stuff like this:

What are your hard things to measure?

The hardest things to measure all have one thing in common: they are vague, intangible, undefined. (They are weasel words.)

If you’re already familiar with my work, you probably already realise we can’t measure what we can’t observe or detect through our five senses. And therein lies the key to making the hard stuff easier to measure. We need to define what exactly we mean; what exactly the thing is that we want to measure.

The way to define exactly what those hard things mean is to ask questions to unpack them, and home in on exactly what about those hard things matters most to us.

Questions like these are easy to ask and exactly what’s needed (and no-one should ever be afraid to ask them):

  • What does ‘thing’ mean, exactly?
  • What does ‘thing’ mean to us, in our situation?
  • What about ‘thing’ is the important part for us?
  • If ‘thing’ was already happening, how would we recognise it?
  • How could we explain ‘thing’ to a 10-year-old?

When you can’t measure something, it’s almost certain you haven’t clearly defined that something.
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What is your hardest thing to measure? Share it on the blog, so we can all play with these questions to make it much easier to measure.

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  1. Nan Solomons says:

    The hardest thing for me to measure is nurses’ adherence to best practice when it has not been documented. The assumption is that the task has not been performed because it wasn’t documented. The reality is that it is likely that the task has been performed, however, the activity was not documented. What is a good proxy for performed but not documented?

    • Stacey Barr says:

      Who can verify, without documentation, that a task has been performed? The nurse?
      What is the value to nurses for documenting that tasks have been performed?
      Would a sample (of tasks and of nurses) be enough to help you track change over time? Or do you need a full population measure (all nurses and all tasks) for regulatory reasons?

  2. Elke Troosters says:

    Hi Stacey,
    One of the struggles we seem to have lately is that we do find some reasonable answers to the questions you raise about ‘the thing’. But when we’re discussing the observations we could measure it is very difficult to formulate the main event or effect and we keep circling around a grouping of data points and calculations rather than 1 clear and concise measure. We then end up in a whole debate about a long list or pyramid of measures to give evidence of that ‘one thing’, where we subsequently get overwhelmed with an incomprehensible dashboard that still does not give clear evidence of ‘the thing’. Do you think that the cause of this phenomenon is that we haven’t gone deep or far enough (the 5 why approach) in answering those questions about the ‘thing’? Have we tried jumping to possible measures too soon?

    • Stacey Barr says:

      Could be a few things, Elke, but often I see it’s this:
      Have your prioritised clearly what exactly about ‘the thing’ matters most? Or are you trying to get evidence of everything that could be important about ‘the thing’? A safework culture is very broad, but maybe the most important thing about a safework culture is that people have safety in their minds before they do anything.

  3. Jo Craven says:

    My team are continuous improvemnt consultants and are invited to other parts of our business (a govt agency) to help them find efficiencies in their processes. Measuring our effectiveness is difficult.Using staff FTE or widgets produced before and after is difficult because you can’t neccessarily attribute any savings or performance improvements to any interventions our consultants recommend. The busines area might use our suggestions as a springboard, but could introduce their own initiatives as well. All we have been able to measure is customer satisfaction and the perceived value we have added for the customer, so we have KPIs around that. Are we missing something and can you see other things we could measure?

    • Stacey Barr says:

      Jo, this sounds like a question of “how can we isolate the impact of a specific change on a specific result?” The only answer is to do the isolating. And that means adopting the principles of business experiment design, where you agree not to make any other changes at the same time as the change you want to measure the impact of. And of course, it’s essential and imperative that the specific results you want to measure an impact on are defined clearly and observable and you have decided what the measure(s) will be before you start the experiment, so you have a baseline.

  4. Jeff Wilkins says:

    As part of our AS9100, quality management system requirements we must measure customer satisfaction. We have used surveys but don’t find it to be effective simply because our customers don’t like filling out surveys. does anyone have a tried and true method for tracking and measuring customer satisfaction?

  5. Wendy Mc says:

    A couple of processes we struggle to measure are clinical handover and patient consent for treatment – not just was the consent form signed but from the patients perspective. Both require participation, engagement and a certain culture which is perhaps why tgey are hard to measure.

    • Stacey Barr says:

      This sounds like something worth experimenting with. Trialing a few ideas in just one or two small locations, or with a very small pilot sample of patients. And as you test different ways to capture the data, get feedback from both parties about how easy or hard it was, and how it could be made easier. Using a well-designed sample in the end, when you’ve decided on the data collection method, will also make it easier and improve response rates and therefore data reliability.

  6. chris hillman says:

    How can you measure a hospital patients journey when they don’t know what’s right or wrong, what is a good experience apposed to a bad one. How do you academically measure the experience when you don’t have an evaluation model

    • Stacey Barr says:

      I guess the short answer is to create some kind of evaluation model. It might start by exploring the question “who decides what’s right or wrong about each step in the journey”? Like any process, a patient’s journey involves and effects different stakeholders, not just the patient. And like any process, there will be different results that matter along the way, to each stakeholder group, including the patients. I suspect it’s less about what is right and wrong, and more about the different attributes that matter to the different stakeholders. Flowcharting the patient journey while you explore which attributes matter to which stakeholders might help you develop a model for evaluation. When you can articulate those attributes as results, then you know what you need to design measures for.

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