You have to know your numbers…

The Foundation of Improvement

I’m going to write a series of short posts relating to the 6 principles we use at Alamac in all our interactions with our partners and with data. As a company we work with partners across all aspects of the health and social care system, acute, community, mental health, primary care and more. We work with teams, using a clinical method to support teams and organisations to manage the system more effectively.

Principle 1 — Know Your Numbers

The first principle is simple, but our experience tells us it’s slightly more difficult than on first appearance, to “know your numbers”… But, in reality, what does that mean. I’ve noted three points that we use with our partners relating to this.

Define it

With a significant number of partners we work with, there is some sort of cleansing / defining of the definition or the data we are discussing. The process, within a complex health and social care system of defining key measures so that partners from across teams / organisations / system partners recognise and understand it is a vital building block of system wide improvement efforts. My challenge to teams I work with is to be really specific in the definition, (I don’t mean narrow in scope) take time over it, and ensure it aligns clearly to the goal that you are trying to achieve.

Own it

We have the great privilege of working with senior and operational NHS leaders’ day in, day out, it’s fantastic to see passionate people, so committed to working better together to improve services for patients. Part of the journey we’ve seen partners go on is taking ownership of their key measures. If I own something, I want to know not just what it is, but why it is. I had a warning light come on in my car last week, I knew what it meant by looking at the manual (defined), but without owning that, the definition became futile. Similarly, we work across health and social care systems to improve relationships, change language and behaviour through supporting organisations to own and understand their numbers. We need to understand ‘cause’. For any system to run effectively, those managing must intimately understand what has caused a key measure to be exactly where it is. This allows ‘effect’. This is where source becomes key — technology know is such a great enabler, but in many cases, in community and social care settings, automated feeds or timely, accurate information is not always the norm. As leaders within these systems, accurate information upon which we base our decisions is infinitely more important that the perceived pain of doing things manually. By all means, automate where you can, but don’t let the desire for a perfect automated feed stall the work you are seeking to do.

Share it

Transparency builds trust, but a perceived lack of transparency will build rumour, myth and stifles growth. In order for a complex health and social care system to function effectively, relationships between providers in fundamental to success. The ability to know your key measures and accurately, transparently and humbly describe the cause of a key measure being where it is, is the most powerful way I’ve seen of building trust between providers. On a call with a local NHS economy last week, an acute provider stated “that delay is completely on us, we just let waiting times get away from us yesterday.” What that did was build trust, but also, when it came to requesting support from others, there was great willingness to draw close and support.

The Alamac Principles

Sorry if this seems overly simple, but I had to start at the very beginning, for if we can’t or don’t do this, our ability to deliver stability to a system greatly diminishes, and like I said in a previous blog post “you cannot land transformational change on a system in chaos.”

Next week, we’ll discuss principle 2, taking and action that delivers a “believed” benefit.

Find out more about our work at or Alamac