A Computer Program for ProMES: ProMES Navigator

A computer program to use with ProMES has been developed by two Swedish colleagues, Kenneth Malm and Fredrik Hendeberg. I was involved in the design of the program, but they have been working on this for years and the current product is excellent. I would not do a ProMES project without using it.

The program has four major sections. The first is designed to enter the information for that particular project. So the names of the objectives and indicators, the contingencies and other project information is entered by the facilitator. The second section identifies who gets access to what information. For example, you can customize the program so that certain personnel get information about one unit’s performance but not another’s. Another major section allows Personal Navigator to be the data entry mechanism for indicators. Indicator data can be entered online by different people in the unit and the program keeps track of this over time and does any calculations needed from this raw data to produce the indicator value for that period. For example, a ProMES project of Kenneth’s involved Swedish police officers entering data at the end of each shift. This took the officer less than 3 minutes, and the data were aggregated by the program into monthly indicator scores. This makes gathering and processing the indicator data much easier.

Where the program truly shines is in producing feedback reports. There is a rich variety of different formats possible and one can look at the data in many different ways. Some examples are shown below from a project in a hospital intensive care unit. A subset of the indicators for this project are shown in the examples.

Nursing Quality Survey

The first screenshot shows performance on one indicator, Scores on a Nursing Quality Survey. The graph on the left shows the effectiveness score over time. When the graphed line is red, performance is below the zero point of minimum acceptable performance. When it is green, it is above this level. The actual indicator data are shown in the table at the bottom left along with percent of maximum effectiveness score, the number of data points making up the mean. The bottom row allows the user to add any text information that might be relevant. E.g., a low indicator score might be caused by a number of unit personnel being on vacation. A note indicating that can be added. When there is something entered, the icon changes color to show there is information available. In the upper left corner is a drop down box labeled Total in the screenshot. If there are multiple groups using the same set of indicators, the user can select different combinations of units to combine in the graph. For example, if there were four ICU’s using the same system, the user can look at each separately or combine them to get an overall picture of performance. The right hand graph is the contingency for this indicator so people can readily see the effects of changes in the effectiveness score with changes in the indicator.

The next screenshot shows the Overall Effectiveness Score over time in the top graph. Again, green is above minimum expected performance and red is below it. The three graphs on the bottom are effectiveness scores for each of the three objectives. I.e. the sum of the indicators for each objective.

Another example of a feedback report is shown below. Here the information is in a different form. Each of the gauge figures is for one indicator. The red, yellow and green colors refer to areas in the contingency. Red is below minimum expectations, yellow is near minimum, and green is above minimum. Note that the area for the three colors is different in each gauge. For example, for the indicator Scores on Nursing Quality Survey there is a large area of red and a large area of green. This reflects the fact that the contingency for that indicator has a large negative side and a large positive side. In contrast, the gauge for Percent Transfusion Blood Wasted has a large yellow and red area, but no green. This means the contingency has no appreciable upside. Minimum performance is wasting no blood and any that is wasted is below minimum expectations. The dark line on the gauge is performance on that indicator for the last period, the lighter line is performance the period prior to that. This makes it easy to see if performance is improving or declining.

This is a very sophisticated program. For example, there are 16 different types of feedback reports. The program has been developed and refined over the years through Kenneth’s extensive experience doing ProMES with his clients. I have also made a number of suggestions that Kenneth and Fredrik have incorporated. If you are going to do ProMES, I strongly suggest you use this program. To learn more about it and for information on pricing, contact Kenneth Malm or see the ProMES Navigator website: ProMES Navigator