Measure the change you actually want to make

What we found in the news

The 2010 NHS improvement handbook (opens in a new tab) begins its improvement model with a question:

“What are we trying to accomplish?”

— The model for improvement, page 145

We are returning to this established guidance because collecting information is often easier than agreeing what a service wants to learn. The practical example below is hypothetical; it is not an evaluated genus intervention.

Why this matters to us

Imagine a community program changing its arrival process. The team would like people to spend less time waiting at reception before joining their activity.

It could count arrivals, completed forms, or staff messages. All might be available. None, on its own, explains whether the new arrangement helps a participant get to the activity they chose.

At genus, we are interested in measures that support a useful decision. A number should help people understand the work, rather than simply give the next report something to display.

Describe the change in everyday terms

Agree what should become easier and for whom. In our hypothetical service, the aim concerns the arrival experience, including whether a person understands the next step and can ask for help.

Check that colleagues share the meaning. One person may think the problem is the reception queue; another may think it is the unclear route to the activity room. They may need different changes.

Ask participants what would make a useful difference. Some may value a shorter wait. Others may want a quieter place to arrive or more time to speak with a familiar colleague. A faster process is not automatically a better one for everybody.

Keep the proposed change small enough to examine responsibly. The team might try a clearer welcome arrangement for one session before changing the whole program.

Choose information that answers the question

Decide what the team needs to observe and how it will be recorded consistently. A simple note about the time between arrival and joining an activity may answer one question. A short conversation may answer another.

Clarify the boundaries of the measure. Does arrival mean entering the building or reaching reception? What happens when someone chooses to have a conversation before joining? Without a shared understanding, the same number can describe different events.

Use information already collected appropriately when it fits the question. Adding another form has a cost for the people completing and reviewing it.

Consider who is missing from the information. A person who stops attending will not appear in an arrival-time sample. Their experience may still matter when the organization decides whether the arrangement is working.

Check what changed elsewhere

A shorter queue at reception could mean that questions have moved to the activity leader. A digital form could save staff time while making preparation harder for some participants.

Look beyond the most visible result. Ask colleagues whether the change created extra calls, corrections, or uncertainty. Ask participants whether they could still get the help they needed.

Compare a reasonable run of experience rather than treating one unusually easy morning as the answer. Record other changes that may explain what the team sees, such as different staffing or attendance.

If the result is unclear, say so. The organization may need a different measure, more observation, or a revised idea. Learning that a change did not work as expected is useful when it informs the next decision.

What this means for the people you serve

People should be able to contribute to what improvement means, not only supply data about it. Explain the purpose of any request for feedback and keep the effort proportionate. Their account can reveal a difficulty that a tidy average conceals.

The genus connection

Configured genus staff tools can bring recorded participation, activity, and available feedback information into review today. The Partner Portal provides workspaces according to the organization’s modules and access arrangements.

The information is only as complete and relevant as the underlying records. It does not establish that genus caused a change in health or service outcomes. We see its role as supporting a closer look, with the team deciding what the evidence can reasonably tell them.

One question for your next team meeting

If our chosen number changes, will we know what decision it should help us make?