Evaluating the Outcome You Changed

In practice

The repositioning schedule from the Part 1 capstones is now in place across the unit. Outcomes management supplies the sequence: define and identify the outcome first, then compare and analyse. The outcome was defined in the original PICOT question as incidence across ninety days, which is why it can be measured now — an outcome named after the change is an outcome chosen to look good. Structure, process and outcome measures are separated. Structure is whether the redistributing surfaces exist. Process is whether repositioning was documented on schedule, which is adherence rather than effect. Outcome is the injury rate itself. A balancing measure is added, because the qualitative study warned of disturbed sleep, and a change that prevents injuries while wrecking sleep has not improved care. The data go on a run chart rather than into a before-and-after pair, because two points cannot separate a trend from noise, and this unit's rate has swung between one and three a month for two years. Nine months of data show the rate settling below the previous median, sustained past the run length needed to call it a signal rather than a wobble. That is internal evidence, and it closes the loop by feeding the next question.