4.7 References

Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. (2009). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd ed.).

Measurement as the second Model for Improvement question: 'How will we know that a change is an improvement?'

Module 4 is explicitly framed as answering the second question of the Model for Improvement. Langley et al. (2009) is the foundational source for the measurement framework this module teaches, including the distinction between outcome, process, and balancing measures.

Perla RJ, Provost LP, Murray SK. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46–51.

Run charts as the preferred QI data display method; annotating with interventions; detecting shifts over time

Section 4 explicitly designates run charts as the preferred display method in QI, describing how to annotate them with intervention dates. The example of a weekly screening run chart posted in the breakroom comes directly from this type of practical application. Perla et al. (2011) is the primary peer-reviewed source for run chart methodology.

Institute for Healthcare Improvement (IHI). (2024). Run Chart Tool.

Run chart tool template and how-to guidance

The IHI Run Chart Tool resource provides an accessible, practical reference for learners implementing this display method. Cited alongside Perla et al. to give both the scholarly and practical sources.

Provost LP, Murray SK. (2011). The Health Care Data Guide: Learning from Data for Improvement.

Types of QI measures (outcome, process, balancing); data collection strategies; displaying data for improvement

Section 2's discussion of quantitative vs. qualitative data types and Section 3's data collection examples (EMR reports, manual logs, spreadsheets, surveys) align with the measurement framework in Provost & Murray's Health Care Data Guide, the leading textbook on QI data use.

Lloyd RC. (2019). Quality Health Care: A Guide to Developing and Using Indicators.

Developing and using QI indicators: what makes a good QI measure

Module 4's guidance on selecting appropriate measures aligned with the AIM, and the emphasis on consistent, simple data over intermittent perfect data, reflects principles in Lloyd's QI indicators guide.

Agency for Healthcare Research and Quality (AHRQ). (2024). Quality Improvement and Patient Safety Resources.

Patient safety measurement: data collection infrastructure in healthcare settings

Module 4's data collection examples (EMR reports, chart audits, direct observation) and the module's emphasis on measurement for safety outcomes align with AHRQ's patient safety measurement resources, which provide the federal infrastructure context for PMHCA data collection.

Zima BT, Murphy JM, Scholle SH, et al. (2013). National quality measures for child mental health care: background, progress, and next steps. Pediatrics, 131(Suppl 1), S38–S49.

National quality measures for child mental health; quantitative outcomes relevant to PMHCA

Module 4's quantitative data examples (screening rates, wait times, 72-hour return rate, follow-up appointment scheduling) mirror the national quality measures documented by Zima et al. This validates that the module is teaching measurement of nationally recognized, clinically meaningful outcomes.

Donabedian A. (1966). Evaluating the Quality of Medical Care. The Milbank Memorial Fund Quarterly, 44(3), 166–206.

Structural measures as the third leg of the measure-type framework in Section 4.2 (Types of Measurement)

Donabedian’s 1966 article is the original source of the structure-process-outcome framework that IHI’s process/outcome/balancing model builds on. Citing it directly credits the foundational academic source behind the structural measure category introduced in this section.

Institute for Healthcare Improvement (IHI). (2024). How to Improve: Model for Improvement — Establishing Measures.

Definitions and examples of process, outcome, and balancing measures; guidance on the number of each type to track

This is IHI’s direct source for the “family of measures” language (outcome, process, balancing) that Section 4.2 is built around, keeping the module’s citation trail consistent with the Model for Improvement framework already referenced elsewhere.

Institute for Healthcare Improvement (IHI). (2023). Quality Improvement Project Measures Worksheet.

Guidance on typically tracking 1–2 outcomes, 3–5 processes, and 1–2 balancing measures per project

Supports Section 4.2’s note that teams don’t need to track all four measure types for every project, giving learners a practical benchmark for how many measures of each type a QI project typically uses.