An empirical evaluation of Tukey's control chart for use in health care and quality management applications.

Abstract:

:Recently in this journal, F. Alemi (Qual Manage Health Care. 2004;13(4):216-221) proposed the use of Tukey's Control Chart because of the unique benefits associated with nonparametric inferential statistics including robust performance with (1) low N sizes, (2) nonnormal data, and (3) the presence of outliers, However, an assumption that applies to virtually all inferential statistical procedures (parametric and nonparametric) is that the observations in question are independent from each other. Unfortunately, there is good reason to suspect violation of this assumption when evaluating quality processes over time (as is often the case in health care settings). In this article, the power (ability to detect real changes in a data process) and type I error (probability of false positives) performance of Tukey's Control Chart technique is empirically evaluated. When observations are not independent, Tukey's Control Chart technique demonstrates unacceptable type I error performance. Additionally, regardless of whether observations are independent, the technique demonstrates low power to detect real effects unless the effects are quite large.

journal_name

Qual Manag Health Care

authors

Borckardt JJ,Nash MR,Hardesty S,Herbert J,Cooney H,Pelic C

doi

10.1097/00019514-200504000-00006

keywords:

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

112-5

issue

2

eissn

1063-8628

issn

1550-5154

journal_volume

14

pub_type

评论,杂志文章
  • An exploratory analysis of the correlation of pain scores, patient satisfaction with relief from pain, and a new measure of pain control on the total dose of opioids in pain care.

    abstract:OBJECTIVE:We explored the associations between opioid dose and multiple measures of pain. STUDY DESIGN AND MEASURES:Thirty-two consecutive patients admitted solely for an acute exacerbation of cancer-related pain or for surgery were followed for their entire hospital stay (115 days of pain). For each hospital day, we ...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/QMH.0000000000000009

    authors: Harting B,Johnson T,Abrams R,Odwazny R,Hasler S,McNutt R,Patient Safety Committee at Rush and the UIC Center for Research Translation.

    更新日期:2013-10-01 00:00:00

  • A curriculum for training quality scholars to improve the health and health care of veterans and the community at large.

    abstract::In 1998, the Veterans Health Administration invested in the creation of the Veterans Administration National Quality Scholars Fellowship Program (VAQS) to train physicians in new ways to improve the quality of health care. We describe the curriculum for this program and the lessons learned from our experience to date....

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200210030-00006

    authors: Splaine ME,Aron DC,Dittus RS,Kiefe CI,Landefeld CS,Rosenthal GE,Weeks WB,Batalden PB

    更新日期:2002-04-01 00:00:00

  • Ambulatory care in the new millennium: the role of consumer information.

    abstract::The past decade has been marked by extensive change in the organization of health care delivery systems (the "supply side" of health care). There has been relatively less change in the nature of the health care consumer (the "demand side" of health care). The emergence of the Internet as a consumer health care technol...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200008020-00009

    authors: Sennett C

    更新日期:2000-01-01 00:00:00

  • Health Care Professionals' Usage and Documentation of a Swedish Quality Registry Regarding Preventive Nutritional Care.

    abstract:OBJECTIVES:To describe health care staff members' usage and documentation in a Swedish quality registry focusing on a preventive care process regarding the risk area of malnutrition among persons with dementia. The preventive care process includes risk assessment, analysis of underlying causes, planning and performing ...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/QMH.0000000000000116

    authors: Johansson L,Wijk H,Christensson L

    更新日期:2017-01-01 00:00:00

  • Control charts 101: a guide to health care applications.

    abstract::A control chart can be an effective way to display process data over time. It can differentiate common cause variation from special cause variation through the application of several probability-based interpretation rules. In addition, a control chart can be helpful in evaluating the effectiveness of a change. There a...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200109030-00003

    authors: Amin SG

    更新日期:2001-04-01 00:00:00

  • Academic quality improvement: new medicine in old bottles.

    abstract::Academic medical centers and clinicians have been slow to embrace continuous quality improvement. The Mount Sinai Medical Center in New York has created a new Department of Health Policy that combines an academic research mission with an administrative mission to demonstrate improving quality of care. This article dis...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-199604040-00006

    authors: Chassin MR,Siu AL

    更新日期:1996-07-01 00:00:00

  • Adapting to the context and learning from earlier experience: the implementation of a national breakthrough collaborative in the context of social services in Sweden.

    abstract:BACKGROUND:Although often used in health care settings as a method for continuous quality improvement, experience with the breakthrough collaborative in nonclinical health care settings is limited. In this article, we report pilot data from a social services collaborative conducted in 2007 to 2009 in Sweden, with speci...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/QMH.0b013e3181c58e20

    authors: Lindgren J

    更新日期:2009-10-01 00:00:00

  • Using control charts to analyze serial patient-related data.

    abstract::The authors collected data from the record of a patient who had recently undergone coronary bypass surgery and used these data to construct control charts. The control charts helped them to interpret the variation in several clinical parameters and to evaluate the clinical responses to this variation. ...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:

    authors: Laffel G,Luttman R,Zimmerman S

    更新日期:1994-10-01 00:00:00

  • The importance of negative feedback and consequences of actions in the design of processes.

    abstract::Like many organizations, Continental Rehabilitation Hospital of San Diego designs and communicates templates and targets for desired changes in behaviors and tracks results. It recognizes and celebrates successes and struggles with its failures. A recent case example demonstrates the importance of generating immediate...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-199706010-00007

    authors: Chaplin E,Bailey M,Barger L,Bruce J,Guzman O,Galleisky G,Thompson-Henry S

    更新日期:1997-10-01 00:00:00

  • Tutorial: planning for data collection. Part II: Designing the study.

    abstract::Part II of this three-part tutorial focuses on the logistics of data collection. The author presents a checklist of things to consider when planning the details of a data collection effort; touches on the topics of bias and stratification; discusses examples of popular data collection methods; and points out some comm...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:

    authors: Plsek PE

    更新日期:1994-07-01 00:00:00

  • An Assessment of Organizational Health Literacy Practices at an Academic Health Center.

    abstract:BACKGROUND:Organizational health literacy is the degree to which an organization considers and promotes the health literacy of patients. Addressing health literacy at an organizational level has the potential to have a greater impact on more health consumers in a health system than individual-level approaches. OBJECTI...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/QMH.0000000000000162

    authors: Prince LY,Schmidtke C,Beck JK,Hadden KB

    更新日期:2018-04-01 00:00:00

  • A Fellowship in Quality Management.

    abstract::The U.S. Healthcare Fellowship in Quality Management at Hahnemann University was developed by a managed health care organization and health science university in order to train physicians in the theory and practice of quality management and clinical outcomes measurement. This article describes in detail the program co...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:

    authors: Paz HL,Paradis J,Zatz S

    更新日期:1996-10-01 00:00:00

  • Application of variables control charts to risk-adjusted time-ordered healthcare data.

    abstract::In a previous article (M. K. Hart, Qual Manag Health Care. 2003;12(1):5-19), the authors presented risk-adjusted control charts applicable for attributes data. The present article discusses a similar class of control charts applicable for variables data that are often skewed. The key feature of these charts is their a...

    journal_title:Quality management in health care

    pub_type: 评论,杂志文章

    doi:10.1097/00019514-200404000-00003

    authors: Hart MK,Robertson JW,Hart RF,Lee KY

    更新日期:2004-04-01 00:00:00

  • Institutionwide pain management improvement through the use of evidence-based content, strategies, resources, and outcomes.

    abstract::The Agency for Health Care Policy and Research pain guidelines and implementation theories were used in this improvement initiative to ensure that evidence-based pain management reached every provider and patient in a large tertiary care hospital. Implementation strategies, products, and outcome measures are described...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-199907020-00004

    authors: Miller EH,Belgrade MJ,Cook M,Portu JB,Shepherd M,Sierzant T,Sallmen P,Fraki S

    更新日期:1999-01-01 00:00:00

  • Health care research: alternative approaches to study design and data analysis.

    abstract::In determining intervention effects, quality improvement researchers typically use statistical testing--Fisher's "significance testing" and/or Neyman and Pearson's "hypothesis testing." Such tests are employed in an effort to demonstrate whether or not a statistically and practically significant difference exists when...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/01.QMH.0000338551.05512.1b

    authors: Baghi H

    更新日期:2008-10-01 00:00:00

  • The synergistic role TQM and reengineering could play in standardizing the European vaccination policy.

    abstract::For the implementation of the proposed European standardized vaccination, total quality management (TQM) and reengineering could be powerful tools with a potentially synergistic effect. In the case examined, nonexplicit TQM prepared the organization in several ways for reengineering: providing the human capital, makin...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200210020-00009

    authors: Dubois HF

    更新日期:2002-01-01 00:00:00

  • Continuous quality improvement and hospital epidemiology: common themes.

    abstract::Recently, many have begun to explore the possibility of using analytical methods associated with continuous quality improvement in the efforts to improve health care. Central to this paradigm is the proposition that such analytical methods can be used to identify and react to variations in the processes and outcomes o...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:

    authors: Howland R,Decker MD

    更新日期:1992-10-01 00:00:00

  • Reengineering the organization: an approach for discontinuous change.

    abstract::Improvement will be constrained by the function-based organizational model found in most health care organizations. Most components of the typical organization are driven by the concept of division of labor. The organization needs to challenge the underlying assumptions and reengineer from top to bottom. Reengineering...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:

    authors: Coan T

    更新日期:1994-04-01 00:00:00

  • Electronic Tracking of Patients in an Outpatient Ophthalmology Clinic to Improve Efficient Flow: A Feasibility Analysis and Benchmarking Study.

    abstract:INTRODUCTION:Real-time location systems (RTLS) and Lean management approaches have been employed to improve patient flow in clinical settings. This study explored the feasibility of using these methodologies in an outpatient resident ophthalmology clinic. METHODS:Patients, providers, and staff in Wilmer Eye Institute ...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/QMH.0000000000000075

    authors: Singman EL,Haberman CV,Appelbaum J,Tian J,Shafer K,Toerper M,Katz S,Kelsay M,Boland MV,Greenbaum M,Adelman R,Thomas RC,Vakili S

    更新日期:2015-10-01 00:00:00

  • Gone but not forgotten: the search for the lost surgical specimens: application of quality improvement techniques in reducing medical error.

    abstract::A lost surgical specimen prompted an investigation of both the human processes and the systemic factors involved in surgical specimen handling regarding how health care organizations approach medical error prevention and patient safety promotion. Quality improvement techniques and the conceptual error model of James R...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200110010-00006

    authors: Slavin L,Best MA,Aron DC

    更新日期:2001-10-01 00:00:00

  • Patient safety and the integration of graduate nurses into effective organizational clinical risk management systems and processes: an Australian study.

    abstract:OBJECTIVES:This article explores and describes key processes facilitating the integration of neophyte graduate nurses into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and clinical risk management (CRM) program. METHODS:This study was undertaken usin...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/01.QMH.0000316994.02039.80

    authors: Johnstone MJ,Kanitsaki O

    更新日期:2008-04-01 00:00:00

  • Extending the application of critical path methods.

    abstract::Most health care organizations are using critical pathways in an attempt to reduce the variation in patient care, improve quality, enhance communication, and reduce costs. Virtually all of the critical path efforts to date have developed tables of treatments, medications, and so forth by day and have displayed them in...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-199503020-00005

    authors: Coffey RJ,Othman JE,Walters JI

    更新日期:1995-01-01 00:00:00

  • A patient-centered decision rule for referral of patients to weight-loss programs.

    abstract:BACKGROUND:The obesity epidemic threatens to shorten life expectancy and reduce the quality of life for large segments of the population. The purpose of this study was to develop a decision rule for referral to a weight-loss program on the basis of the relationship between body mass index (BMI) and self-rated overall h...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/01.QMH.0000281061.15108.f8

    authors: Rohrer JE,Merry SP,Lopez-Jimenez F,Adamson SC,Wilshusen L

    更新日期:2007-07-01 00:00:00

  • Safe Passage: Improving the Transition of Care Between Triage and Labor and Delivery.

    abstract:OBJECTIVE:The multifaceted nature of the transition of care from the triage unit to labor and delivery has historically led to confusion, delays, and errors in care. This study evaluated the effect of standardization of roles and communication on improving this transition. METHODS:A multidisciplinary team was assemble...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/QMH.0000000000000191

    authors: Lee DD,Colwill AC,Teel J,Srinivas SK

    更新日期:2018-10-01 00:00:00

  • Proving the effectiveness of community programs in jeopardy: the role of formative evaluation.

    abstract::Today's health care programs are being scrutinized like never before and yet few clinicians and managers know how to show the value of programs without time-consuming outcomes research. This is especially true for new and innovative programs that are dependent on outside funding and may not have enough time to show an...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200109040-00005

    authors: Quinn DC

    更新日期:2001-07-01 00:00:00

  • Using indicators to structure quality improvement initiatives in long-term care.

    abstract::Quality indicators and a quality-monitoring system developed for use in the regulatory survey process offer a quality improvement tool for nursing home staff. The systematic use of resident assessment data can aid in the identification of quality of care problems and the determination of the nature of those problems. ...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-199604030-00008

    authors: Karon SL,Zimmerman DR

    更新日期:1996-04-01 00:00:00

  • Application of attribute control charts to risk-adjusted data for monitoring and improving health care performance.

    abstract::This article proposes a new class of control charts that may be used for monitoring and improving the quality of care. Unlike conventional control charts that rely on observed performance data, these charts use risk-adjusted data in addition to the observed data. The resulting time-ordered charts are capable of reduci...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200301000-00004

    authors: Hart MK,Lee KY,Hart RF,Robertson JW

    更新日期:2003-01-01 00:00:00

  • Toward an understanding of competency identification and assessment in health care management.

    abstract::Given the revolutionary changes occurring in the health care industry, there is increasing agreement that academicians and practitioners must collaborate to identify and prioritize major educational outcomes for health care management. Several competency initiatives have been undertaken or completed in health care and...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-200211010-00006

    authors: Calhoun JG,Davidson PL,Sinioris ME,Vincent ET,Griffith JR

    更新日期:2002-10-01 00:00:00

  • A framework for collaborative improvement: lessons from the Institute for Healthcare Improvement's Breakthrough Series.

    abstract::The article describes the Breakthrough Series, a collaborative improvement model developed by the Institute for Healthcare Improvement. The model adapts and applies existing knowledge to multiple, similar sites to accomplish common aims. It has been used to address several of the most pressing issues in health care to...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:10.1097/00019514-199806040-00001

    authors: Kilo CM

    更新日期:1998-09-01 00:00:00

  • Continuous improvement in health care: transforming the hospital department.

    abstract::Each department in a hospital is given the responsibility of managing its own day-to-day work. For the hospital as a whole to change, the individual departments must undergo a similar change. As each department aligns itself with the purposes of the whole organization, synergy is created and the hospital gradually, in...

    journal_title:Quality management in health care

    pub_type: 杂志文章

    doi:

    authors: Strickland B,Hardison CD

    更新日期:1993-10-01 00:00:00