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FIGURES
FIGURE 1.1 Model for Improvement
FIGURE 1.2 The PDSA cycle
FIGURE 1.3 Sequential PDSA Cycles for Learning and Improvement
FIGURE 1.4 PDSA Cycles from Testing to Implementation
FIGURE 1.5 Results of a Before-and-After Test: Case
FIGURE 1.6 Other Possible Run Charts Associated with Before-and-After Graph
FIGURE 1.7 Analysis of Data from a PDSA Cycle
FIGURE 1.8 Run Charts of Key Measures for Diabetes Improvement Project
FIGURE 2.1 Sources of Data
FIGURE 2.2 Measurement for Judgment versus Improvement
FIGURE 2.3 Moving from Judgment to Improvement Measures
FIGURE 2.4 Using Percentile Rankings
FIGURE 2.5 Measure Based on an Index Instead of Actual Units
FIGURE 2.6 Simple Scales for Turning Personal Experience into Data
FIGURE 2.7 Percentage of DRG Exceeding LOS Guidelines Indicating Improvement
FIGURE 2.8 Percentage of Unplanned Readmissions Worsening
FIGURE 2.9 Multiple Measures on a Single Graph
FIGURE 2.10 Surgical Safety FOM
FIGURE 2.11 Image Reflective of an Enumerative Study
FIGURE 2.12 Image Reflective of an Analytic Study
FIGURE 2.13 Large Sample Compared to Small Sample
FIGURE 2.14 Sample Size and Ability to Detect Change
FIGURE 2.15 Stratification Involves Separation and Classification
FIGURE 2.16 Shewhart Chart of Post-CABG Complication Rate Without Stratification
FIGURE 2.17 Post-CABG Complication Rate Stratified by Protocol
FIGURE 2.18 Little Difference Between Risk-Adjusted and Non-Risk-Adjusted Data
FIGURE 2.19 Large Differences Between Risk-Adjusted and Non-Risk-Adjusted Data
FIGURE 2.20 Run Chart of Number of Falls
FIGURE 2.21 Run Chart of Rate of Falls
FIGURE 2.22 Graphs of Fall Rate and Number of Falls
FIGURE 2.23 Patient Waiting Time
FIGURE 2.24 Tools to Learn from Variation in Data
FIGURE 2.25 Scatter Plots for Data in Table 2.18
FIGURE 3.1 Historical Example of a Run Chart
FIGURE 3.2 Run Chart Example
FIGURE 3.3 Run Chart Leading to Questions
FIGURE 3.4 Run Chart with Labels and Median
FIGURE 3.5 Run Chart with Goal Line and Tests of Change Annotated
FIGURE 3.6 Stat Lab Run Chart with No Evidence of Improvement
FIGURE 3.7 Improvement Evident Using a Set of Run Charts Viewed on One Page
FIGURE 3.8 Run Charts Used as Small Multiples
FIGURE 3.9 Run Chart Displaying Multiple Measures
FIGURE 3.10 Run Chart Displaying a Different Measure for Each Axis
FIGURE 3.11 Run Chart Displaying Multiple Statistics for the Same Measure
FIGURE 3.12 Run Chart with Little Data
FIGURE 3.13 Run Chart with Clinic Team Uncertain About Improvement
FIGURE 3.14 Four Rules for Identifying Nonrandom Signals of Change
FIGURE 3.15 Run Chart Evaluating Number of Runs
FIGURE 3.16 Measure with Too Few Runs
FIGURE 3.17 Run Chart with Too Many Runs
FIGURE 3.18 Run Charts of Clinic Cycle Time
FIGURE 3.19 Average Time to Administer Antibiotics
FIGURE 3.20 Three Key Uses of Run Charts in Improvement Initiatives
FIGURE 3.21 Beginning a Run Chart as Soon as the First Data Are Available
FIGURE 3.22 Run Charts for Waiting Time Data
FIGURE 3.23 Delay Detecting Signal with Proper Median Technique
FIGURE 3.24 Detecting Signal with Proper Median Technique
FIGURE 3.25 Detecting Signal of Improvement with Two Medians
FIGURE 3.26 Two Cases When Median Ineffective on Run Chart
FIGURE 3.27 Run Chart of Incidents Resulting in Too Many Zeros
FIGURE 3.28 Run Chart of Cases between an Incident
FIGURE 3.29 Starting and Updating Chart of Cases between Undesirable Rare Events
FIGURE 3.30 Mature Run Charts Tracking Cases Between Rare Events
FIGURE 3.31 Use of Data Line on Run Chart
FIGURE 3.32 Data from Unequal Time Intervals Displayed in Usual Run Chart
FIGURE 3.33 Data From Unequal Time Intervals Displayed to Reveal Impact of Time
FIGURE 3.34 Run Chart from Figure 3.22 With Seventh Week Added
FIGURE 3.35 Run Chart with Inappropriate Use of Trend Line
FIGURE 3.36 Run Chart of Autocorrelated Data from a Patient Registry
FIGURE 3.37 Run Chart with Percentage Doubled in Most Recent Month
FIGURE 3.38 Shewhart Control Chart (P Chart) Adjusting Limits Based on Denominator Size
FIGURE 3.39 Infant Mortality Data Stratified Using a Run Chart
FIGURE 3.40 Harm Data Stratified Using a Run Chart
FIGURE 3.41 Multi-Vari Chart
FIGURE 3.42 Run Chart and CUSUM Run Chart of Patient Satisfaction Data
FIGURE 4.1 Using Shewhart Charts to Give Direction to an Improvement Effort
FIGURE 4.2 Example of Shewhart Chart with Equal Subgroup Size
FIGURE 4.3 Example of Shewhart Chart with Unequal Subgroup Size
FIGURE 4.4 Rules for Detecting a Special Cause
FIGURE 4.5 Detecting "Losing the Gains" For an Improved Process
FIGURE 4.6 Depicting Variation Using a Run Chart versus a Shewhart Chart
FIGURE 4.7 Shewhart Charts Common Cause and Special Cause Systems
FIGURE 4.8 Shewhart Chart Revealing Process or System Improvement
FIGURE 4.9 Shewhart Chart Using Rational Subgrouping
FIGURE 4.10 Shewhart Chart Using Stratification
FIGURE 4.11 Shewhart Charts Depicting a Process or System "Holding the Gain"
FIGURE 4.12 Run Charts and Shewhart Charts for Waiting Time Data
FIGURE 4.13 Improper and Proper Extension of Baseline Limits on Shewhart Chart
FIGURE 4.14 Dealing with Special Cause Data in Baseline Limits
FIGURE 4.15 Recalculating Limits After Special Cause Improvement
FIGURE 4.16 Recalculating Limits after Exhausting Efforts to Remove Special Cause
FIGURE 4.17 Stratification of Laboratory Data with a Shewhart Chart
FIGURE 4.18 Disaggregation of ADEs Data
FIGURE 4.19 ADE Rate Rationally Subgrouped in Different Ways
FIGURE 4.20 Shewhart Chart Meeting Goal but Unstable
FIGURE 4.21 Shewhart Chart Stable but Not Meeting Goal
FIGURE 4.22 Special Cause in Desirable Direction
FIGURE 4.23 Shewhart Chart with Special Cause in Undesirable Direction
FIGURE 4.24 Shewhart Chart for LOS
FIGURE 4.25 Percentage of Patients with an Unplanned Readmission
FIGURE 5.1 Shewhart Chart Selection Guide
FIGURE 5.2 I Chart for Volume of Infectious Waste
FIGURE 5.3 I Chart Extended and Updated with New Limits
FIGURE 5.4 Rational Ordering for an I Chart for Intake Process
FIGURE 5.5 I Chart for Budget Variances
FIGURE 5.6 Xbar S Chart for Radiology Test Turnaround Time
FIGURE 5.7 Xbar S Chart for LOS
FIGURE 5.8 Xbar S Chart for LOS by Provider
FIGURE 5.9 Xbar and S Chart Subgrouped by Provider and Quarter
FIGURE 5.10 Xbar S Chart Showing Improvement in Deviation from Start Times
FIGURE 5.11 P Chart for Percentage of Patients Harmed
FIGURE 5.12 Extended P Chart for Percentage of Patients Harmed
FIGURE 5.13 P Chart Showing Second Phase After Improvement
FIGURE 5.14 P Chart for Percentage of Unplanned Readmissions
FIGURE 5.15 P Chart for Percentage of MRSA for Hospital System
FIGURE 5.16 Funnel Plot of P Chart for Percentage of MRSA for Hospital System
FIGURE 5.17 P Chart with Funnel Limits for Systemwide Medication Compliance
FIGURE 5.18 C Chart for Employee Needlesticks
FIGURE 5.19 C Chart for Issues by Surgeon
FIGURE 5.20 U Chart for Flash Sterilization
FIGURE 5.21 U Charts Showing the Effect of Choosing the Standard Area of Opportunity
FIGURE 5.22 U Chart for Complaints by Clinic with Funnel Limits
FIGURE 5.23 Comparison of G Chart to U Chart
FIGURE 5.24 G Chart for ADEs
FIGURE 5.25 T Chart for Number of Days between ADEs
FIGURE 5.26 Different Formats for Displaying a T Chart
FIGURE 5.27 T Chart for Retained Foreign Objects
FIGURE 5.28 Process Capability: Typical Situations and Actions
FIGURE 5.29 Capability From an I Chart
FIGURE 5.30 Capability Analysis from an Xbar S Chart
FIGURE 6.1 Tools to Learn from Variation in Data
FIGURE 6.2 Histogram, Dot Plot, and Stem-and-Leaf Plot for Age at Fall
FIGURE 6.3 Frequency Plot (Dot Plot) of Patient Satisfaction Data
FIGURE 6.4 Age of Children with Head Injury
FIGURE 6.5 Shewhart Chart of Average Minutes to Initiate Antibiotics for Sepsis Patients
FIGURE 6.6 Histogram of Minutes to Antibiotic Start for Patients with Sepsis
FIGURE 6.7 Stable Shewhart Chart of Patient Fall Rate
FIGURE 6.8 Histogram of Age of People Who Fell
FIGURE...
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