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| List of Exhibits, Tables, and Figures | |
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| Acknowledgments | |
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| Preface | |
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| What Is SPC? | |
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| Why Write Another Book on SPC for Healthcare? | |
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| The Organization of This Book | |
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| Introduction | |
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| Why Do Some Healthcare Professionals Find Measuring Quality a Difficult Task? | |
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| Who Wants to See Healthcare Quality Measured? | |
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| Purchasers of Care | |
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| Accreditation Agencies | |
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| Governing Bodies | |
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| General Public | |
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| Providers | |
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| Why Are Different Approaches to Measurement Needed? | |
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| Using Data for Improvement: Basic SPC Theory and Methods | |
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| Basic SPC Concepts and the Run Chart | |
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| A Simple Process Improvement Plan | |
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| Before and After Measures | |
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| Types of Variation | |
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| The Run Chart | |
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| What Is a Run Chart? | |
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| What Is a "Run"? | |
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| What Are the Tests for a Special Cause? | |
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| Case Study: Reducing Delays from Abnormal Mammogram to Biopsy | |
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| Control Chart Theory Simplified | |
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| Control Charts versus Run Charts | |
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| Basic Elements | |
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| Detecting Special Causes | |
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| Should the Tests for a Special Cause Ever Be Modified? | |
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| How Many Subgroups Are Required for a Control Chart? | |
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| Choosing the Appropriate Control Chart | |
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| Identifying the Type of Data | |
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| Deciding on the Best Chart | |
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| Case Study: Reducing Readmissions for Congestive Heart Failure | |
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| Advanced SPC Theory and Methods | |
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| Drilling Down into Aggregated Data | |
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| The Challenge | |
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| Create the Appropriate Control Chart at the Aggregate Level | |
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| Response to Special Cause Variation | |
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| Response to Common Cause Variation | |
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| Stratify All Organizational Units on the Same Control Chart | |
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| Rational Ordering | |
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| Rational Subgrouping | |
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| Respond Appropriately to the Observed Variation | |
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| Create a Separate Control Chart for Each Organizational Unit | |
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| Stratify on Other Process Variables | |
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| Case Study: Reducing C-Section Rates | |
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| Case Study: Cycle Times for Laboratory Analysis in the Emergency Department | |
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| Issues with Control Charts | |
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| Determining the Number of Subgroups | |
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| Trial Limits | |
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| The Capability of a Process | |
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| Histograms | |
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| Capability Ratios | |
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| Probability Plots | |
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| Control Charts | |
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| Graphical Guidelines for Constructing Control Charts | |
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| Displaying the Raw Data | |
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| Chart Titles | |
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| I-Charts | |
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| Zones versus No Zones | |
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| Using the X-Bar and S-Chart in Place of the X-bar and R-Chart | |
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| About the X-Bar and S-Chart | |
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| Case Study: Improving the Post-Operative Care of Heart Surgery Patients | |
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| Autocorrelated Data | |
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| Limitations of Attribute Charts | |
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| Assumption of Equal Probability | |
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| Using I-Charts in Place of Attribute Charts | |
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| Case Study: Neonatal Autopsies | |
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| Skewness | |
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| Subgroups Sizes for P-Charts | |
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| Case Study: An HMO Evaluates Its Providers for CAGB Surgery | |
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| Case Study: Code Blues in the ICU | |
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| Monitoring "Rare Events" | |
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| Case Study: Evaluating a Bowel Surgery Pathway | |
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| Obtaining Meaningful Data | |
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| General Principles of Measurement | |
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| Types of Measures | |
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| Domains of Quality | |
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| Outcome versus Process Measures | |
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| Continuous Measures versus Count Measures | |
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| Sampling Methods | |
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| Stratified Random Sampling | |
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| Rational Sampling | |
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| Guidelines for Developing Indicators | |
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| Benchmarking | |
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| What Is Benchmarking? | |
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| Identifying the "Best" | |
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| Benefits of Benchmarking | |
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| Setting Goals and Targets | |
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| Comparison Data | |
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| Measuring Goal Achievement | |
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| Special Applications of SPC Theory and Methods | |
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| Using Patient Feedback for Quality Improvement | |
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| Patient Satisfaction versus Functional Assessment | |
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| Uses of Patient Satisfaction Data | |
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| Identifying Important Issues | |
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| Measuring the Current Level of Satisfaction | |
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| Assessing the Effect of Interventions | |
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| Setting Goals | |
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| Qualitative versus Quantitative Data | |
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| Case Study: Improving Nursing Care among Inpatients | |
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| Case Study: Improving Satisfaction with Physicians in an Outpatient Setting | |
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| Governance and Monitoring Quality | |
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| Organiaztional Structure | |
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| Role of Governance with Respect to Quality | |
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| Conducting Productive Meetings | |
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| Developing a Balanced Scorecard | |
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| Concepts | |
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| Development Guidelines | |
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| Displaying and Reviewing Scorecard Data | |
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| Dashboard Displayed in Tabular Format | |
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| Dashboard Displayed in Control Chart Format | |
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| Historical Charts | |
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| Multi-Charting | |
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| Six Sigma | |
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| What Is Six Sigma? | |
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| Six Sigma As a Statistic | |
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| Six Sigma As a Program | |
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| Origin of the Six Sigma Program | |
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| How Does Six Sigma Differ from SPC? | |
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| Effectiveness in Healthcare | |
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| Setting Specification Limits | |
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| Hospital Organization versus Industry | |
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| Improving Profitability | |
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| SPC versus Six Sigma | |
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| The Use of Run and Control Charts in the Improvement of Clinical Practice | |
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| Evaluating Baseline Performance | |
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| Displaying the Data Graphically | |
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| Cholesterol Management | |
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| The Use of Warfarin for Anticoagulation | |
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| Diabetic Patient with Hypertension | |
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| The Use of Control Charts in Clinical Medicine | |
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| Summary | |
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| SPC Software and the Formulas for Calculating Control Limits | |
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| References | |
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| About the Authors | |
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| Index | |