Formula for surgical practice resuscitation in an academic medical center

Application of statistical process control in healthcare improvement: systematic review

OBJECTIVE

To systematically review the literature regarding how statistical process control--with control charts as a core tool--has been applied to healthcare quality improvement, and to examine the benefits, limitations, barriers and facilitating factors related to such application.

DATA SOURCES

Original articles found in relevant databases, including Web of Science and Medline, covering the period 1966 to June 2004.

STUDY SELECTION

From 311 articles, 57 empirical studies, published between 1990 and 2004, met the inclusion criteria.

METHODS

A standardised data abstraction form was used for extracting data relevant to the review questions, and the data were analysed thematically.

RESULTS

Statistical process control was applied in a wide range of settings and specialties, at diverse levels of organisation and directly by patients, using 97 different variables. The review revealed 12 categories of benefits, 6 categories of limitations, 10 categories of barriers, and 23 factors that facilitate its application and all are fully referenced in this report. Statistical process control helped different actors manage change and improve healthcare processes. It also enabled patients with, for example asthma or diabetes mellitus, to manage their own health, and thus has therapeutic qualities. Its power hinges on correct and smart application, which is not necessarily a trivial task. This review catalogs 11 approaches to such smart application, including risk adjustment and data stratification.

CONCLUSION

Statistical process control is a versatile tool which can help diverse stakeholders to manage change in healthcare and improve patients' health.

Improving productivity through the use of portable radios

Orthopaedic practices are under increasing pressure to improve productivity in the ambulatory setting. Best practice use of portable radios or walkie-talkies help to achieve a near 50% reduction in patient visit time without reducing the time spent with the care provider. More patients may be seen or the same number in less time. Increased staff communication saves wasted steps and decreases the response time in patient emergencies. A variety of radios and accessory equipment may be needed to meet the needs of each user and to overcome any structural interference. Successfully instituting this practice change involves time-motion studies, assigning a project manager, and full leadership support. The emission of radio frequency waves by portable radios or their transmitting power may interfere with implanted pacemakers or external medical equipment. But the risk is low when radios are used away from individual patients.