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Nightingale Challenge

While in London on vacation I made a point of seeking out all things Nightingale. Unfortunately, the museum was closed for renovations. There were two striking memorials I did visit: one at St Paul's Cathedral and the other at Waterloo Place, pictured here.

Florence Nightingale's contribution to quality improvement was nothing short of breakthrough. Two facts I learned while in London suggest a persistent Nightingale Challenge to guide improvement.

First was her work improve hygiene practices in military hospitals resulting in a dramatic reduction in the infection-related mortality rate among wounded soldiers - from 40% to 2%!

Second was her interest in making statistics visible and understandable. Apparently in order to advocate for improvement in military procedures she needed to persuade Queen Victoria and felt that a report composed of text and tables of numbers would not be convincing. The coxcomb graph (animated on this page) was an attempt to turn data into a picture that could be easily understood. This graph has not stood the test of time, and a simpler presentation of the same data is probably appropriate. The point is she recognized the need to make data understandable and convincing.

So, the Nightingale challenge is twofold: set out to accomplish dramatic improvement by setting stretch goals, think 40 to 2. And, use meaningful data that answers important questions displayed in a simple manner such as run charts annotated with change; tell a story that anyone can follow.

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