A measurement system for spread includes the main outcome measures of the process or system of interest (e.g., adverse drug events) and the rate of spread of the specific improvements (e.g., number of care units using unit briefings to identify safety problems). In addition to the measurement system, a feedback system is needed to provide information on progress in reaching the organization’s spread goals to the executive leadership, the spread agent and the spread team, and the adopters in the target population.

There are important considerations in expanding a data collection approach from a single pilot site to the system level. As with all measurement for improvement, to reduce the burden of data collection, sampling should be used in assessing improvement in spread projects. Other things to consider in collecting data at the system level include availability of data in automated systems, building data collection into the current patient care process, and refining the sampling plan.