Statistical Process Control for Hospitals

Abstract

The health care industry is slowly embracing the use of statistical process control (SPC) to monitor and study causes of variation in health care processes. While the statistics and principles underlying the use of SPC are relatively straightforward, there is a need to be cognizant of the perils that await the user who is not well versed in the key concepts of SPC. This article introduces the theory behind SPC methodology, describes successful tactics for educating users, and discusses the challenges associated with encouraging adoption of SPC among health care professionals. To illustrate these benefits and challenges, this article references the National Hospital Quality Measures, presents critical elements of SPC curricula, and draws examples from hospitals that have successfully embedded SPC into their overall approach to performance assessment and improvement.

Impact of providing patient information leaflets prior to hospital discharge to patients with acute kidney injury: a quality improvement project

“… 33 There is a ‘rule of 7’ that is generally applied to demonstrate changes that are unlikely to have occurred by chance. 34 35 The SPC for this project demonstrated that following the norovirus outbreak there are more than 7 points under the mean, 11 points, and therefore it is reasonable to assume that this is unlikely to occur by chance.…”

Control Charts Usage for Monitoring Performance in Surgery: A Systematic Review

“…The introduction of control charts in healthcare is recent, compared with its original application to the manufacturing industry. 2,3,[7][8][9][10]20 Most articles in this review focused on adapting control chart methodology and testing its utility to detect significant variations in surgical care retrospectively. While quality metrics in industry allow direct and easy analyses of production processes, the interpretation of surgical outcomes and particularly patient safety seems less straightforward.…”

“…The introduction of control charts in healthcare is recent, compared with its original application to the manufacturing industry 2,3,7–10,20 . Most articles in this review focused on adapting control chart methodology and testing its utility to detect significant variations in surgical care retrospectively.…”

“…2,3 After being proven as remarkably effective at enhancing manufacturing of products or services, 4 it has been applied to health care for continuous performance improvement. [5][6][7][8][9][10] A key component of SPC is the control chart, a graphical tool for data interpretation that detects unusual indicator variations inherent to special causes that can be identified and resolved. 11 Several types of charts exist based on the same principle of successive indicator measurements plotted chronologically, with control limits demarcating the expected variations.…”

“…Statistical process control (SPC) is a quality improvement method developed a century ago by Walter Shewhart 2,3 . After being proven as remarkably effective at enhancing manufacturing of products or services, 4 it has been applied to health care for continuous performance improvement 5–10 . A key component of SPC is the control chart, a graphical tool for data interpretation that detects unusual indicator variations inherent to special causes that can be identified and resolved 11 .…”