The design, selection, and performance of statistical control charts for healthcare process improvement

Although the value of Statistical Process Control (SPC) charts to monitor and improve healthcare processes has received growing interest, several important implementation and theoretical issues are largely not understood. SPC charts are chronological graphs of process data that are used in many other industries to help control and improve quality and, while based in statistical theory, are easy for practitioners to use and interpret. This article provides an overview of the use of SPC in healthcare process improvement and Six Sigma activities, including the process of selecting and using the appropriate type of control chart, their statistical performance, and the guidelines for determining the appropriate sample sizes. The operating characteristics are computed and tabulated for a wide range of scenarios in order to aid practitioners in designing control charts with the desired statistical properties.