Sunday, 4 November 2012

Measuring Up to the Acronyms and Numbers

For many reasons, last week saw me preoccupied with thoughts of measurement. This stream of consciousness was started by the story that staff working at the Department of Health had racked up a bill for £331,644 on ‘refreshments’ for staff and visitors last year. This story is set against a back cloth of the NHS having to make £20bn of savings by 2015, with many hospitals reducing the numbers of nurses and other health care professionals. I wondered what was being measured here – after the entire overall budget for the NHS is nearly £110bn, give or take a million or so.

So my quest was on. The numerical metric is king, and these days it feels like we have Key Performance Indicators (KPIs) for everything. But as William Deming the great management theorist has reminded us, relying only on measurable figures without consideration of figures that are unknown or unknowable is one of the big 7 ‘deadly diseases’ of many organisations. Numbers can sometimes be verifiable, but as Universities have seen with the introduction of Key Information Sets (KIS). KIS is meant to provide comparable sets of information about undergraduate courses. It has been designed to meet the information needs of prospective students (or more likely their parents) when choosing a University. But a quick scan through the Unistats website shows that there is little uniformity in the way degree programmes are described.

And how does one truly measure ‘satisfaction’- a key indicator in the KIS and National Student Survey (NSS) metrics. What does 89% overall satisfaction mean? Is 89% satisfaction in Bristol the same as 89% satisfaction in Bolton, or Bradford? Likewise, is it  possible to ever measure happiness, being in love, or future success? Daniel Kahneman, the Nobel Prize winning economist and psychologist has had a go at measuring happiness. He said below an income of £37,332 a year, people are unhappy, and they get progressively unhappier the poorer they get. Above that, there is an absolutely flat line of happiness. Money does not buy you experiential happiness, but lack of money certainly buys you misery.

As reported here earlier in the year an Australian mathematics professor, Tony Dooley at the University of New South Wales created an equation, nicknamed the ‘Fiancée Formula’ which works by factoring in the age at which you start looking for a long-term partner and the absolute oldest age you would consider getting married. However, his mathematical equation for love only has a 37% success rate.

Future success? Well Daniel Kahneman again, he notes we don’t choose between experiences, we choose between memories of experiences. Even when we think about the future, we don’t think of our future normally as experiences. We think of our future as anticipated memories. A notion, however, which relies upon developing a reference point which can be used to make judgements about what we have done without still being able to measure what it we might have achieved. In the KIS information this measure is the number of students who get a graduate job - which is like knowing the cost of everything but the value of nothing.

Health Education England, the new body responsible for spending some £7bn on educating and training the health care workforce has come up with a plan to do tackle this issue – perhaps borrowing from the Research Excellence Framework rhetoric, that want to establish a clear line of sight between education and service improvements and patient outcomes. Their Education Outcomes Framework focuses on 5 domains: Excellent education; Competent and capable staff; Adaptable and flexible workforce; NHS values and behaviours’; Widening participation. Each has metrics developed to a greater or lesser degree. It is the values and behaviours domain I am particularly interested in, and this is the area that is perhaps the hardest to measure. If anyone was going to ask me how I would address this area I would like to say it would be through my ability to create positive ripples throughout the whole School and beyond so that colleagues find inspiration for making nuanced and creative contributions to the lives of others – just how I would ever measure this though is the difficult part – all thoughts welcome.