BACKGROUND There is debate about the role of crude mortality rates and case-mix adjusted mortality rates in monitoring the outcomes of treatment. In the context of quality improvement a key purpose of monitoring is to identify special cause variation as this type of variation should be investigated to identify possible causes. This paper investigates agreement between the identification of spec...

Background and objectives: Risk-adjusted Bernoulli control chart is one of the main tools for monitoring multistage healthcare processes to achieve higher performance and effectiveness in healthcare settings. Using parameter estimates can lead to significantly deteriorate chart performance. However, so far, the effect of estimation error on this chart in which healthcare ...

OBJECTIVES To determine whether an innovative graphical tool for accurate measurement of individual surgeon performance metrics, adjusted for both surgeon-specific and patient-specific factors, significantly alters interpretation of performance data. DESIGN Retrospective analysis of all total knee replacements (TKRs) conducted at the host institution between 1996 and 2009. The database was ra...

The cumulative sum (CUSUM) procedure is a graphical method that is widely used for quality monitoring in industrial settings. More recently it has been used to monitor surgical outcomes whereby it 'signals' if sufficient evidence has accumulated that there has been a change in the surgical failure rate. A limitation of the standard CUSUM procedure in this context is that since it is simply base...

Monitoring binary outcomes when evaluating health care performance has recently become common. Classical statistical methodologies such as cumulative sum (CUSUM) charts have been refined and used for this purpose. For instance, the risk-adjusted CUSUM chart (RA-CUSUM) for monitoring binary outcomes was proposed for monitoring 30-day mortality following cardiac surgery. The RA-CUSUM inherits opt...

In recent years risk-adjusted control charts have been increasingly studied for monitoring surgical outcomes by accounting for patients’ health conditions prior to surgery. However, most existing research focuses on phase II monitoring, and very little work has been done on phase I control of surgical outcomes. In this paper, a general phase I risk-adjusted control chart is proposed for monitor...