Value What We Measure, or Measure What We Value?

Do we value what we measure, or do we measure what we value?
This is not a play on words. It turns out that we often end up valuing what is easy to measure and what we are asked to measure.

Valuing What We Are Asked to Measure
The quantified self movement has proliferated the use of constant data acquisition to guide decision making. But when simply measuring what we are asked to measure, without first discerning its value, we get lost in the sea of numbers. Consequently, we get lost at sea. Why are we measuring “this” in the first place?

There is a hidden cost involved in measuring things that is of low value. Due to a perverse incentive, when we measure things that are of low value, we
1. Tax our resources;
2. Demotivate ourselves from focusing on high-value factors, and mort importantly,
3. Relegate things that are of higher value that are worth our attention.

Take for example, if we start to track the number of projects that an employee is working on, instead of measuring the value of what someone is delivering, even if he is involved in only one project, we are likely to evaluate his contribution on a lower rank. We have missed the point.

Closer to home, to much of her own surprise, a therapist’s aggregated outcome data shows that she has indeed improved her clinical effectiveness over the years. No easy feat. But this came at a cost: Unlike her colleagues, she didn’t take on other “side-projects” in the organisation, nor was she trying to climb the corporate ladder. Not only she is not recognised for this magnificent achievement, she is being devalued because, based on the annual key performance indicators (KPIs), she didn’t meet the mark.

Organisations easily fall prey to valuing what we measure. Often no one is to blame, but we end up unchallenging the flaws. For instance, we think that measuring customer satisfaction is a good measure of success (side note: Most good enough companies would score high on these measures anyway).

For practitioners like you, using a symptom-specific measure might be useful in some cases, but at times may be of low-value to a client. A practitioner may inadvertently start to value what’s being measured. One time, a colleague was telling me why he didn’t want to use a measure of well-being to track his clients’ outcomes. “My job is to treat the symptoms.”

A symptom can be reduced in treatment, but the client’s life functioning might not necessarily improve. If a client is struggling with auditory hallucinations, he may want to deal with his voice hearing experience, and he may also want to work on getting a job, or to be more connected with people that matter in his life. 
People can work on improving their well-being, in spite of their symptoms. A symptom-specific measure alone would not be able to reflect this nuance.

Measuring What We Value
While it is more challenging, the call for all of us is to discern and systematically track what results are of the highest value. Michael Porter and his colleagues call this a value-based approach (i.e., outcomes divided by the cost of the delivering the care).[1] Measure what is of value for consumers of services, and not just lowering costs, increasing caseloads, etc.

Maybe we should also begin to appreciate and reward devoted practitioners who are able to raise their bar of performance over time and deliberate practice. Why? Because better results not only motivates the practitioner, but better results is also paramount to our clients.

Take the time to ask ourselves, what is of true value, and for whom is it valuable to? Then, measure that.

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Footnotes:

[1] Redefining Healthcare by Michael Porter and Elizabeth Teisberg.  Other brilliant reads on this topic:
– 4 Disciplines of Execution by Chris McChesney, Sean Covey, and Jim Tulin. 
– Measure What Matters by John Doeer.

[2] Here’s some hints on what could be of value to someone seeking help: Improving the quality of life, wellbeing, and life satisfaction (note: We tend to conflate life satisfaction and wellbeing. Life satisfaction is a measure of your recollection of your past self. On the other hand, wellbeing is a measure of your present self. Daniel Kahneman calls this the remembering self vs the experiencing self.)

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