{"id":6476,"date":"2016-02-10T09:00:30","date_gmt":"2016-02-10T13:00:30","guid":{"rendered":"http:\/\/www.coreeducationllc.com\/blog2\/?p=6476"},"modified":"2016-02-05T23:28:21","modified_gmt":"2016-02-06T03:28:21","slug":"how-measurement-fails-doctors-and-teachers","status":"publish","type":"post","link":"https:\/\/www.coreeducationllc.com\/blog2\/how-measurement-fails-doctors-and-teachers\/","title":{"rendered":"How Measurement Fails Doctors and Teachers"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"http:\/\/www.coreeducationllc.com\/blog2\/is-tfa-still-a-good-idea\/newyorktimes\/\" rel=\"attachment wp-att-1928\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-1928\" src=\"https:\/\/i0.wp.com\/www.coreeducationllc.com\/blog2\/wp-content\/uploads\/2012\/09\/newyorktimes.jpg?resize=294%2C190\" alt=\"newyorktimes\" width=\"294\" height=\"190\" srcset=\"https:\/\/i0.wp.com\/www.coreeducationllc.com\/blog2\/wp-content\/uploads\/2012\/09\/newyorktimes.jpg?w=530&amp;ssl=1 530w, https:\/\/i0.wp.com\/www.coreeducationllc.com\/blog2\/wp-content\/uploads\/2012\/09\/newyorktimes.jpg?resize=300%2C194&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.coreeducationllc.com\/blog2\/wp-content\/uploads\/2012\/09\/newyorktimes.jpg?resize=463%2C300&amp;ssl=1 463w\" sizes=\"auto, (max-width: 294px) 100vw, 294px\" \/><\/a>In a recent opinion piece in the New York Times, Robert Wachter focuses on the effects of metrics and measurement on the health care and education professions. While arguing that we, of course, need to hold professionals accountable, he cautions against unanticipated consequences. Following is an excerpt from this piece:<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">Measurement cannot go away, but it needs to be scaled back and allowed to mature. We need more targeted measures, ones that have been vetted to ensure that they really matter. In medicine, for example, measuring the rates of certain hospital-acquired infections has led to a greater emphasis on prevention and has most likely saved lives. On the other hand, measuring whether doctors documented that they provided discharge instructions to heart failure or asthma patients at the end of their hospital stay sounds good, but turns out to be an exercise in futile box-checking, and should be jettisoned.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">We also need more research on quality measurement and comparing different patient populations. The only way to understand whether a high mortality rate, or dropout rate, represents poor performance is to adequately appreciate all of the factors that contribute to these outcomes \u2014 physical and mental, social and environmental \u2014 and adjust for them. It\u2019s like adjusting for the degree of difficulty when judging an Olympic diver. We\u2019re getting better at this, but we\u2019re not good enough.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Most important, we need to fully appreciate the burden that measurement places on professionals, and minimize it. In health care, some of this will come through advances in natural language processing, which may ultimately allow us to assess the quality of care by having computers \u201cread\u201d the doctor\u2019s note, obviating the need for all the box-checking. In both fields, simulation, video review and peer coaching hold promise.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Whatever we do, we have to ask our clinicians and teachers whether measurement is working, and truly listen when they tell us that it isn\u2019t. Today, that is precisely what they\u2019re saying.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Avedis Donabedian, a professor at the University of Michigan\u2019s School of Public Health, was a towering figure in the field of quality measurement. He developed what is known as Donabedian\u2019s triad, which states that quality can be measured by looking at outcomes (how the subjects fared), processes (what was done) and structures (how the work was organized). In 2000, shortly before he died, he was asked about his view of quality. What this hard-nosed scientist answered is shocking at first, then somehow seems obvious.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">\u201cThe secret of quality is love,\u201d he said.<\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400;\">Our businesslike efforts to measure and improve quality are now blocking the altruism, indeed the love, that motivates people to enter the helping professions. While we\u2019re figuring out how to get better, we need to tread more lightly in assessing the work of the professionals who practice in our most human and sacred fields.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">Read the full piece here: <\/span><a href=\"http:\/\/www.nytimes.com\/2016\/01\/17\/opinion\/sunday\/how-measurement-fails-doctors-and-teachers.html\" target=\"_blank\"><span style=\"font-weight: 400;\">http:\/\/www.nytimes.com\/2016\/01\/17\/opinion\/sunday\/how-measurement-fails-doctors-and-teachers.html<\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In a recent opinion piece in the New York Times, Robert Wachter focuses on the effects of metrics and measurement on the health care and education professions. While arguing that we, of course, need to hold professionals accountable, he cautions against unanticipated consequences. Following is an excerpt from this piece: Measurement cannot go away, but <a href=\"https:\/\/www.coreeducationllc.com\/blog2\/how-measurement-fails-doctors-and-teachers\/\" rel=\"nofollow\"><span class=\"sr-only\">Read more about How Measurement Fails Doctors and Teachers<\/span>[&hellip;]<\/a><\/p>\n","protected":false},"author":1,"featured_media":1928,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[9,6],"tags":[198,176,42,61],"class_list":["post-6476","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-teacher-effectiveness-retention","category-teacher-evaluation","tag-educator-effectiveness","tag-teacher-assessments","tag-teacher-effectiveness","tag-teacher-evaluation-2"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>How Measurement Fails Doctors and Teachers - Core Education, LLC<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.coreeducationllc.com\/blog2\/how-measurement-fails-doctors-and-teachers\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"How Measurement Fails Doctors and Teachers - Core Education, LLC\" \/>\n<meta property=\"og:description\" content=\"In a recent opinion piece in the New York Times, Robert Wachter focuses on the effects of metrics and measurement on the health care and education professions. 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