Resources for the use of Statistical Process Control in Healthcare

Someone on the MedStats email discussion group asked for resources that “explain the use of SPC (statistical process control) to analyze quality indicators in a healthcare organization.”

I’m working on some research grants to use control charts to provide guidance to continuing review and monitoring of clinical trials. The most recent page that discusses this is at:

• Stats: My second grant, part 2 (September 13, 2006)

I also may end up giving a talk for PharmaIQ, a division of the International Quality & Productivity Center (IQPC), and they look to have a lot of interesting conferences on healthcare and quality. Of course, my opinion is probably biased by the belief that any group that invites me to talk must have a good appreciation of talent. The Healthcare IQ section actually looks to be quite interesting.

There’s a lot out there, and this is only a partial list. I tried to include only those resources that had a direct link to health care, with the exception of Donald Wheeler’s book, which is a worthwhile read for anyone in any discipline.

Books:

• Measuring Quality Improvement in Healthcare: A Guide to Statistical Process Control Applications. Raymond G. Carey, Robert C. Lloyd (1995) New York: Quality Resources.
• Risk Adjustment for Measuring Health Care Outcomes, Third Edition. Lisa I Iezzoni (2003) Chicago, IL: Health Administration Press. [BookFinder4U link]
• Understanding Variation: The Key to Managing Chaos. Donald J. Wheeler (1993) Knoxville, TN: SPC Press Inc. [BookFinder4U link]

Research papers:

• Hospital volume and surgical mortality in the United States. J. D. Birkmeyer, A. E. Siewers, E. V. Finlayson, T. A. Stukel, F. L. Lucas, I. Batista, H. G. Welch, D. E. Wennberg. New England Journal of Medical 2002: 346(15); 1128-37. [Medline]
• Use of combined Shewhart-CUSUM control charts in internal quality control of enzyme-linked immunosorbent assays for the typing of foot and mouth disease virus antigen. S. D. Blacksell, L. J. Gleeson, R. A. Lunt, C. Chamnanpood. Rev Sci Tech 1994: 13(3); 687-99. [Medline]
• Views of practicing physicians and the public on medical errors. R. J. Blendon, C. M. DesRoches, M. Brodie, J. M. Benson, A. B. Rosen, E. Schneider, D. E. Altman, K. Zapert, M. J. Herrmann, A. E. Steffenson. N Engl J Med 2002: 347(24); 1933-40. [Medline]
• Making the case for personal professional monitoring in health care. S. Bolsin, M. Colson. Int J Qual Health Care 2003: 15(1); 1-2. [Medline] [PDF]
• Was Bristol an outlier? D. Carr. Lancet 2001: 358(9298); 2083; discussion 2084.
• Monitoring intensive care unit performance using statistical quality control charts. William H Chamberlin, Kevin A Lane, James N Kennedy, Scott D Bradley, Charles L Rice. International Journal of Clincial Monitoring and Computing 1993: 10(3); 155-161. [Medline]
• Mortality in Low Birth Weight Infants According to Level of Neonatal Care at Hospital of Birth. Javier Cifuentes, Janet Bronstein, Ciaran S. Phibbs, Roderic H. Phibbs, Susan K. Schmitt, Waldemar A. Carlo. Pediatrics 2002: 109(5); 745-751. [Abstract]
• Developing Control Charts to Review and Monitor Medication Errors. Joseph L Ciminera, Michael P Lease. Hospital Pharmacy 1992: 27(3); 192-193, 195-197. [Medline]
• Implementing comprehensive quality control in the andrology laboratory. S. Clements, I. D. Cooke, C. L. Barratt. Hum Reprod 1995: 10(8); 2096-106. [Medline]
• Individual assessment of antihypertensive response by self-starting cumulative sums. G. Cornelissen, F. Halberg, D. Hawkins, K. Otsuka, W. Henke. J Med Eng Technol 1997: 21(3-4); 111-20. [Medline]
• It’s the quality that counts. G. Dunea. British Medical Journal 1998: 317(7156); 480. [Medline] [Full text] [PDF] (Model, Quality, Skeptical viewpoint)
• Cusums to measure chronic daily headache. E. Freidank-Mueschenborn, A. W. Fox. Headache 2006: 46(1); 110-4. [Medline] [Abstract] [Full text]
• Health Care Leader Employs Quality Improvement Software. Robert Green. Quality Digest 1999; 57.
• Use of risk-adjusted CUSUM and RSPRT charts for monitoring in medical contexts. O. A. Grigg, V. T. Farewell, D. J. Spiegelhalter. Stat Methods Med Res 2003: 12(2); 147-70. [Medline] [Abstract] [PDF]
• Use of Statistical Control Charts to Assess Outcomes of Medical Care: Pneumonia in Medicare Patients. Roger Hand, Frank Piontek, Linda Klemka-Walden, Dale Inczauskis. Am J Med Sci 1994: 307(5); 329-334. [Medline]
• Using laboratory-based surveillance data for prevention: an algorithm for detecting Salmonella outbreaks. L. C. Hutwagner, E. K. Maloney, N. H. Bean, L. Slutsker, S. M. Martin. Emerg Infect Dis 1997: 3(3); 395-400. [Medline] [PDF]
• Five times: coincidence or something more serious? Miles Irving, Donald M Berwick, Peter Rubin, Tom Treasure. British Medical Journal 1998: 316(7146); 1736. [Full text]
• A provocative look at performance measurement. B. M. Jennings, N. Staggers. Nursing Administration Quarterly 1999: 24(1); 17-30. [Medline] [Abstract] [Full text]
• Public confidence and cardiac surgical outcome. Cardiac surgery: the fall guy in medical quality assurance. B. E. Keogh, J. Dussek, D. Watson, P. Magee, D. Wheatley. British Medical Journal 1998: 316(7147); 1759-60. [Medline] [Full text] [PDF]
• A broader concept of medical errors. T. H. Lee. N Engl J Med 2002: 347(24); 1965-7. [Medline]
• Statistical process control tools for monitoring clinical performance. T. O. Lim. Int J Qual Health Care 2003: 15(1); 3-4. [Medline] [Full text] [PDF] (Medicine, Quality)
• Relationship Between Low Quality-of-Care Scores and HMOs' Subsequent Public Disclosure of Quality-of-Care Scores. D. McCormick, D. U. Himmelstein, S. Woolhandler, S. M. Wolfe, D. H. Bor. Jama 2002: 288(12); 1484-90. [Medline] [Abstract] [Full text] [PDF] (Medicine, Quality)
• Application of the CuSum technique to evaluate changes in recruitment strategies. P. McNees, K. H. Dow, V. W. Loerzel. Nurs Res 2005: 54(6); 399-405. [Medline] [Abstract] [Full text] [PDF] (Model, Quality)
• Association of hospital procedure volume and outcomes in patients with colon cancer at high risk for recurrence. J. A. Meyerhardt, P. J. Catalano, D. Schrag, J. Z. Ayanian, D. G. Haller, R. J. Mayer, J. S. Macdonald, A. B. Benson, 3rd, C. S. Fuchs. Ann Intern Med 2003: 139(8); 649-57. [Medline] [Abstract] [Full text] [PDF] (Medicine, Quality)
• Patient safety events during pediatric hospitalizations. M. R. Miller, A. Elixhauser, C. Zhan. Pediatrics 2003: 111(6 Pt 1); 1358-66. [Medline] [Abstract] [Full text] [PDF] (Medicine, Quality)
• Creating the evidence base for quality improvement collaboratives. B. S. Mittman. Ann Intern Med 2004: 140(11); 897-901. [Medline] [Abstract] [PDF] (Medicine, Quality)
• Bristol, Shipman, and clinical governance: Shewhart’s forgotten lessons. M. A. Mohammed, K. K. Cheng, A. Rouse, T. Marshall. Lancet 2001: 357(9254); 463-7. [Medline] (Model, Quality, Example)
• Primary care practice-based research networks: working at the interface between research and quality improvement. J. W. Mold, K. A. Peterson. Ann Fam Med 2005: 3 Suppl 1; S12-20. [Medline] [Abstract] [Full text] [PDF] (Model, Quality)
• Implementation of the ANA Report Card. Katherine Moore, Mary R. Lynn, Bradley J. McMillen, Sandra Evans. Journal of Nursing Administration 1999: 29(6); 48 - 54. [Medline] (Medicine, Quality)
• The use of statistical process control methods in monitoring clinical performance. A. P. Morton. Int J Qual Health Care 2003: 15(4); 361-2; author reply 363. [Medline] [PDF] (Model, Quality)
• An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia. D. J. Muscatello, T. Churches, J. Kaldor, W. Zheng, C. Chiu, P. Correll, L. Jorm. BMC Public Health 2005: 5; 141. [Medline] [Abstract] [Full text] [PDF] (Model, Quality)
• Use of the Cusum technique for evaluation of a CT-based navigation system for total knee replacement. R. S. Nizard, R. Porcher, P. Ravaud, E. Vangaver, D. Hannouche, P. Bizot, L. Sedel. Clin Orthop Relat Res 2004: (425); 180-8. [Medline] [Abstract] [Full text] [PDF] (Model, Quality)
• The learning curve of an academic cardiac surgeon: use of the CUSUM method. R. J. Novick, L. W. Stitt. J Card Surg 1999: 14(5); 312-20; discussion 321-2. [Medline] (Model, Quality)
• Quality assurance in radiotherapy of breast cancer--variability in planning target volume delineation. M. A. Pitkanen, K. A. Holli, A. T. Ojala, P. Laippala. Acta Oncol 2001: 40(1); 50-5. [Medline] [PDF] (Model, Quality control)
• Innovative thinking for the improvement of medical systems. P. Plsek. Ann Intern Med 1999: 131(6); 438-44. [Medline] [Abstract] [PDF] (Model, Quality)
• Retrospective cohort study of false alarm rates associated with a series of heart operations: the case for hospital mortality monitoring groups. J. Poloniecki, C. Sismanidis, M. Bland, P. Jones. Bmj 2004: 328(7436); 375. [Medline] [Abstract] [Full text] [PDF] (Model, Quality)
• Cumulative risk adjusted mortality chart for detecting changes in death rate: observational study of heart surgery [published erratum appears in BMJ 1998 Jun 27; 316(7149):1947]. J. Poloniecki, O. Valencia, P. Littlejohns. British Medical Journal 1998: 316(7146); 1697-700. [Medline] [Abstract] [Full text] [PDF] (Model, Quality Control)
• Human error: models and management. J. Reason. Bmj 2000: 320(7237); 768-70. [Medline] [Full text] [PDF] (Model, Quality)
• Use of public performance reports: a survey of patients undergoing cardiac surgery. EC Schneider, AM Epstein. JAMA 1998: 279(20); 1638-42. [Medline] [Abstract] (Medicine, Quality)
• A surveillance system based on a short memory scheme. D. L. Shore, D. Quade. Stat Med 1989: 8(3); 311-22; discussion 331-2. [Medline] (Model, Quality)
• Why TQM can’t stand for top quality medicine. Gerard Smedinghoff. Contingencies 1996: (48); 49-51. (Model, Quality)
• Risk-adjusted sequential probability ratio tests: applications to Bristol, Shipman and adult cardiac surgery. DJ Spiegelhalter, O Grigg, R Kinsman, T Treasure. Int J Qual Health Care 2003: 15(1); 7-13. [Medline] [Abstract] [Full text] [PDF] (Medicine, Quality)
• Monitoring surgical performance using risk-adjusted cumulative sum charts. SH Steiner, RJ Cook, VT Farewell, T Treasure. Biostatistics 2000: 1(4); 441-52. [Medline] [Abstract] (Medicine, Quality)
• The State of Statistical Process Control as We Proceed into the 21st Century. Z.G. Stoumbos, Jr. Reynolds, M.R. , R.P. Ryan, W.H. Woodall. Journal of the American Statistical Association 2001: 95(451); 992-998. [Abstract] [PDF] (Model, Quality)
• Underperforming doctors: a postal survey of the Northern Deanery. George Taylor. BMJ 1998: 316(7146); 1705-8. [Medline] [Abstract] [Full text] [PDF] (Medicine, Quality)
• Problems for clinical judgement: 4. Surviving in the report card era. JV Tu, MJ Schull, LE Ferris, JE Hux, DA Redelmeier. CMAJ 2001: 164(12); 1709-12. [Medline] [Abstract] [Full text] [PDF] (Medicine, Quality)
• Statistical analysis of real-time PCR data. J. S. Yuan, A. Reed, F. Chen, C. N. Stewart, Jr. BMC Bioinformatics 2006: 7; 85. [Medline] [Abstract] [Full text] [PDF] (Model, Quality)

Websites:

• The measurement and monitoring of surgical adverse events. J. Bruce, E. M. Russell, J. Mollison, Z. H. Krukowski. Accessed on 2003-08-15. (Medicine, Quality). www.ncchta.org/fullmono/mon522.pdf
• The Seven Fatal Flaws of Performance Measurement. Joseph F. Castellano, Saul Young, Harper A. Roehm, Published June 2004 in the The CPA Journal Online. Accessed on 2006-03-24. (Model, Quality control)<U+FFFD> www.nysscpa.org/cpajournal/2004/604/essentials/p32.htm
• Preventing Hospital Falls: The quality profession’s major contribution to the world is the ability to scientifically investigate process variation.. Thomas Pyzdek, Published in the May 1999 issue of Quality Digest. . Accessed on 2004-03-11. (Model, Quality, Example) www.qualitydigest.com/may99/html/spcguide.html
• Minnesota hospitals' report on “never events” released. Andis Robeznieks, Published in Amercian Medical News on February 21, 2005. Accessed on 2005-02-16. (Medicine, Quality) www.ama-assn.org/amednews/2005/02/21/prsc0221.htm