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If You Can't Measure Performance, Can You Improve It?

“If you can’t measure it, you can’t manage it” is an often-quoted admonition commonly attributed to the late W. Edwards Deming, a leader in the field of quality improvement. Some well-respected health policy experts have adopted as a truism a popular variation of the Deming quote—“if something cannot be measured, it cannot be improved”—and point to the recent enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as a confirmation of “the broadening societal embrace” of this concept.

The problem is that Deming actually wrote, “It is wrong to suppose that if you can’t measure it, you can’t manage it—a costly myth” (my emphasis added)—the exact opposite. Deming consistently cautioned against requiring measurement to guide management decisions, observing that the most important data needed to manage often are unknown and unknowable.

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