I found myself thinking about metrics a great deal this last week. Every organisation I have ever worked in has used metrics – measurements designed to assess some quantifiable component of performance. The logic is simple – data captured and collated on the correct parameters will provide an accurate view of what’s going on in an organisation and will encourage the right (and improved) performance. The key to success, of course, is choice of ‘correct parameters’.
Unfortunately there are all sorts of examples – in and out of our industry – where this focus on metrics has actually led to worse performance…more waste…disengaged colleagues…or all three!
A classic example took place in the National Health Service few years back when UK Government decided that no patient should have to wait more than 48 hours to see their primary care physician. So convinced was Government that this measure would be a route to improved performance that budget, bonus and salary was tied up in medical centres achieving this metric.
And sure enough, waiting times decreased rapidly. Success! Maybe…maybe not?
More detailed analysis revealed that many medical centres introduced policies preventing appointments being booked in advance; policies that forced patients to attend on the day they rang up.
So the metric was achieved – medics had space in their calendars to see people within 48 hours and waiting lists were effectively eliminated. On the other hand, with so many people calling to make a booking every day, it became virtually impossible to get through to a practice on any specific day to get an appointment. And – needless to say – anyone who liked to plan ahead was similarly ill-served.
Things have got better more recently, but this ‘targets culture’ had a negative impact on patients and healthcare alike, through a focus on the wrong metric – in this case waiting times rather than quality of care. Culturally we can be addicted to metrics – we deliver what is measured…especially if it’s measured by our leaders and if it feeds into our performance assessment.
In our own industry, many of us have experienced periods when individual units or departments succeeded in achieving their own annual metrics…but the organization as a whole fails to deliver.
So now focus is not just on metrics but also on the search for that elusive ‘correct metric’ – a metric that provides an accurate view of what’s going on and that drives the right performance. A metric that is easy to collect and collate!
And the cultural dimension remains strong. Performance will always be dependent on the practices and values embedded in any individual organization – how things are done around here. But a culture of transparency will always help…a culture where colleagues feel able to speak out – to critique or to praise alike. Where mistakes are not hidden but are reviewed for learning and improvement. Where successes are celebrated…and are reviewed for learning and improvement.
We are all moving from being ‘product or service based’ to being focused on ‘outcomes or overall experience’. This is a change to celebrate. But it is also a change that requires even better (and simpler) metrics…and fewer metrics. We all know that trying to measure everything is a sure-fire route to decreased productivity and increased frustration.
A quality metric has to be accurate – it should measure what it says it will measure. A quality metric has to be aligned with an organisation’s goals. A quality metric has to be aligned with individual goals. Making any number go up, or come down, through our actions and reactions, has little real value unless those numbers are related to why we come to work each day.