ArticleBMC health services research2020
Statistical process monitoring to improve quality assurance of inpatient care.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Article
- Application of statistical process control for monitoring bulk tank milk somatic cell count of smallholder dairy farms.Veterinary world · 2020Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStatistical Process Monitoring (SPM) is not typically used in traditional quality assurance of inpatient care. While SPM allows a rapid detection of performance deficits, SPM results strongly depend on characteristics of the evaluated process. When using SPM to monitor inpatient care, in particular the hospital risk profile, hospital volume and properties of each monitored performance indicator (e.g. baseline failure probability) influence the results and must be taken into account to ensure a fair process evaluation. Here we study the use of CUSUM charts constructed for a predefined false alarm probability within a single process, i.e. a given hospital and performance indicator. We furthermore assess different monitoring schemes based on the resulting CUSUM chart and their dependence on the process characteristics.
methodsWe conduct simulation studies in order to investigate alarm characteristics of the Bernoulli log-likelihood CUSUM chart for crude and risk-adjusted performance indicators, and illustrate CUSUM charts on performance data from the external quality assurance of hospitals in Bavaria, Germany.
resultsSimulating CUSUM control limits for a false alarm probability allows to control the number of false alarms across different conditions and monitoring schemes. We gained better understanding of the effect of different factors on the alarm rates of CUSUM charts. We propose using simulations to assess the performance of implemented CUSUM charts.
conclusionsThe presented results and example demonstrate the application of CUSUM charts for fair performance evaluation of inpatient care. We propose the simulation of CUSUM control limits while taking into account hospital and process characteristics.
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