Statistical Methods of Risk-Adjusted Statistical Process Control Charts to Assess Surgical Performance in Consecutive Colorectal Operations at a Single Institution

Abstract

Discussion | The VA uses the O to E ratio method, which estimates performance by using group-level data that produces an O to E ratio that almost always has a value greater than 0. When comparing patient-level outcomes, the ability to adjust for risk using the O to E ratio is limited for patients for whom no complications occurred, and the curve is more dependent on the number of events in a short time span, rather than being dependent on each patient's outcome related to presurgical risk.The visual presentation of the risk-adjusted cumulative summation chart (O − E) allows for an examination of the process in control events, in better-than-expected performance, and in out-of-control events. The use of real-time cumulative summation (O − E) complements the existing O to E ratio method to provide an informative, real-time visual representation of ongoing surgical performance. It may provide a more intuitive presentation of the process of care to health care providers and administrators.

Preparatory Time–Related Hand Surgery Operating Room Inefficiency: A Systems Analysis

“…As a robust graphical statistical tool, control charts are used in a variety of industries to identify modifiable variations in a process. Within health care, control charts have been implemented in quality improvement in a variety of fields, 29-35 ranging from military injuries to transplant lists to neonatal care. Control charts determine whether a process is in control—minimum nonrandom or “assignable” variation with predictable variation.…”

A prospective phase II clinical trial/IDEAL Stage 2a series of single‐port robotic colorectal surgery for abdominal and transanal cases

“…Statistical process control analysed the docking time process across the transanal and abdominal cohorts.Statistical process control combines sequential, time-based analysis methods with graphical presentation of performance and quality data in a control chart format[31]. This allows clear visualization of outliers and the point where performance stabilizes[32]. The k value (number of standard deviations that the upper and lower control limits are placed away from the centre line [CL]) was 2.…”