Statistical process control charts for attribute data involving very large sample sizes: a review of problems and solutions.

Abstract:

:The use of statistical process control (SPC) charts in healthcare is increasing. The primary purpose of SPC is to distinguish between common-cause variation which is attributable to the underlying process, and special-cause variation which is extrinsic to the underlying process. This is important because improvement under common-cause variation requires action on the process, whereas special-cause variation merits an investigation to first find the cause. Nonetheless, when dealing with attribute or count data (eg, number of emergency admissions) involving very large sample sizes, traditional SPC charts often produce tight control limits with most of the data points appearing outside the control limits. This can give a false impression of common and special-cause variation, and potentially misguide the user into taking the wrong actions. Given the growing availability of large datasets from routinely collected databases in healthcare, there is a need to present a review of this problem (which arises because traditional attribute charts only consider within-subgroup variation) and its solutions (which consider within and between-subgroup variation), which involve the use of the well-established measurements chart and the more recently developed attribute charts based on Laney's innovative approach. We close by making some suggestions for practice.

journal_name

BMJ Qual Saf

journal_title

BMJ quality & safety

authors

Mohammed MA,Panesar JS,Laney DB,Wilson R

doi

10.1136/bmjqs-2012-001373

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

362-8

issue

4

eissn

2044-5415

issn

2044-5423

pii

bmjqs-2012-001373

journal_volume

22

pub_type

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