Design, Use, and Performance of Statistical （设计、使用和性能统计）.pdf

Design, Use, and Performance of Statistical Control Charts for Clinical Process Improvement James C. Benneyan, Ph.D. * Northeastern University, Boston MA Last Revised: September 16, 2001 Abstract Background: The utility of statistical process control (SPC) methods has received growing interest in the healthcare community to help improve clinical and administrative processes. SPC charts are chronological graphs of process data that are used in many other industries to help understand, control, and improve processes and that, although based in statistical theory, are easy for practitioners to use and interpret. Objectives: The objective of this article is to provide an overview of SPC charts, the differ- ent types and uses of control charts, when to use each chart type, their statistical performance, and simple methods for determining appropriate sample sizes. The intended audience in- cludes practitioners and healthcare researchers seeking either an introduction to these meth- ods or further insight into their design and performance. Methods for dealing with rare events and low occurrence rates also are discussed. Methods: Recent empirical examples are used to illustrate appropriate applications of each chart type, sample size determination, and chart performance. Sensitivities are calculated and tabulated for a wide range of scenarios to aid practitioners in designing control charts with desired statistical properties. Conclusions: Control charts are valuable for analyzing and improving clinical process out- comes. Different types of charts should be used in different applications and sample size guidelines should be used to achieve the desired sensitivity and