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Comparing the proportions in two populations – with binary outcome. This popular article shows you how to do it — and why it matters. Check it out: spcforexcel.com/knowledge/comp… #ComparingTwoProportions #SPCforExcelSoftware #SPCTips #DataAnalysis #SixSigma

If you look up #spctips there is some free tips there waiting for you.

Persuasion: people expect and rely on us to follow the procedure. Incentivisiation: Us doing the procedure right will show effective leadership and others will follow our lead. Coercion: If it becomes known we failed to follow the procedure we will be punished. #spctips

Primer on SPCs 16) Saw an SPC tweeted last night as an example of process improvement. DO NOT USE COMPUTER GENERATED SPCs UNLESS YOU CAN TELL IF THE CL IS IN THE RIGHT PLACE BY LOOKING AT THE CHART AND, YOU HAVE READ AND UNDERSTAND THIS... #spctips

SPC is a branch of statistics comparable in rigour and validity to traditional statistical methods. SPCs often yield insights into data more quickly, and provide greater understanding to the lay decision makers than traditional statistical tools. Benneyan et al 2006 #SPCtips

Primer on SPCs 14) "Under optimal conditions, these [SPC] graphical depictions of process performance allow participants to know what is happening within their processes as 'real-time' data enable them to make appropriate decisions... #SPCtips

Restarted #SPCtips in preparation for IPS talk in Feb. Like the earlier ones, response is low. I am undaunted, by the response but I now included an ACC = anticipated cricket count, 3 crickets = minimal response anticipated. 📉🙂

Primer on SPCs 13) Don't just think of SPCs as the chart you need to produce in order to demonstrate and generate improvement. SPCs are charts which show the variability in a system / end product or proxy thereof. They will tell you if change is improvement. #SPCtips

Primer on SPCs 12) When looking at an SPC you are looking to see if the system that generated the results is stable and in control. Ergo, you must be aware of everything in a system that could be awry.... #SPCtips

Primer on SPCs 11) Scottish volcanologist Ian Stewart asked, If you want to take the temperature of the world where would you stick the thermometer and how often would you measure it?' Answer all over the world and continuously. #SPCtips

Primer on SPCs 10) What are you trying to do with an SPC is a) identify variation in the chart and b) communicate that variation so that people are motivated to take action. If the chart is too difficult to read or you cannot explain it in a few short sentences.... #SPCtips

Primer on SPCs #SPCtips 9) The C chart is a numerator only chart. It is useful for discrete data where the 'area of the opportunity' remains constant. Alas, the pandemic will have reduced the utility of this type of chart as....

Primer on SPCs 8) The use of SPCs for QI is a bit of a misnomer. They are so much more useful than just improvement. a) they can be used to monitor for deterioration in real-time. #SPCtips

Primer on SPCs 7) The best way to read an SPC is to start with this question. Does the Centre Line run through the centre of the results? Note, its the Centre Line (and not the mean). #SPCtips

Primer on SPCs 5) The adage 'every system is perfectly designed to get the results it gets' helps with understanding variation. The results the system is producing as seen in the SPC (cont blood cultures, alert organisms, BSIs, SSIs, Abx ) are a result of system design. #SPCtips

Primer on SPCs 5) An SPC can exhibit natural variation or be out of statistical control & exhibit unnatural variation. Being out of statistical control can be positive or negative, eg, an increase of infections (negative) or a decrease in cont blood cultures (positive) #SPCtips

A chart exhibiting unnatural variation indicates that something in the system has changed (for better or worse). Think about arrival time for work without disruption (natural variation), and when there is travel disruption (unnatural variation). #SPCtips

3a) The question you are asking of your SPC chart is this: Is the system that resulted in this chart stable and in control? To be able to do that you need to understand variation. Tomorrow variation. #SPCtips

Primer on SPCs 3) examples of use of SPCs in healthcare: Staph aureus bacteraemias, total alert organisms, specific alert organisms, failures to isolate, SSIs, hand hygiene, faecal specimens (to detect noro outbreaks), contaminated blood cultures, etc., etc. #SPCtips

Primer on SPCs 1) QI is not about SPCs per se. Its about monitoring and improving systems using SPCs, other QI tools, and your knowledge of the system and how it is operating. #SPCtips

SPC tips No 10 The average of all results does not make a good CL. Remove the extreme results and try again… See #SPCtips No 9

Experiential destinations are the future, in Sunnyvale CA Whole Foods will soon unveil a Town Center including 198 apartments and 52,000-square-foot theater. #retailtrends2k18 #SPCtips

SPC tips No 11 Having remove the outliers from the calculation of the average, the new Centre Line of 2 (rounded) fits better. Reference work to support this tomorrow... #SPCtips

30 Here are examples of elements in the system that could result in poor data. It is important to identify what is preventing optimum practice. Its not so much about omissions or people getting it wrong, as finding what is provoking errors and preventing safety. #SPCtips

38: 21 results in a row below the pre-intervention CL. The CL no longer runs through the centre of the results. The benefit of not changing the CL for each new result is that the impact of any change can be clearly seen and measured. The CL needs changed now. #SPCtips

33. Tip 30 looked at opportunities to err. This time opportunities the IPCT could explore to help he system. #SPCtips

25 There are few reasons to raise the CL, but you should look for opportunities to reduce it. Recalculate the CL from new results. Suggested comment is on the chart. Positive feedback can have positive results. #SPCtips

22 The first intervention is feedback, which may optimise performance. Once feedback begins, make space for new results. Don’t add new results to recalculate the CL, you want to determine if post-feedback performance is stable compared to the pre-feedback results. #SPCtips

29 Consider a single ward, or other unit of care, a micro-system. The elements in the system: people (patients, HCWs & visitors), the environment, methods, equipment, a culture, information & micro-organisms. Opportunities to improve the system are contained therein. #SPCtips

24: Investigations found no change in the ‘area of opportunity’, ergo assumption is the system, with regular intelligence, has improved. 12 months post-feedback average is 1.22 (pre-feedback 2). Where to put the post-feedback CL, and how to communicate this tomorrow. #SPCtips

23: 12 post feedback are in. All at or below the CL. What happens next? Enough to change the CL? Anything in the area of opportunity changed to suggest results something other than improvement? Suggested action – investigate the system. “Tell me ward manager……” #SPCtips

39 The Semmelweis effect had already started to wane prior to him leaving the building. Its always difficult to be sure if system improvements will be sustained. (Sorry for the time between tips delay) #SPCtips

35 Results are above the upper and below the lower control limits. Outbreaks suggested by Semmelweis (p82). “…whole rows would become ill without a single patient in the row remaining healthy” Task: identify the outbreaks and remove from CL calculation #SPCtips

34 The proportion of deaths from puerperal fever in the Vienna hospital prior to the appointment of Semmelweis. Initial p chart. Tomorrow - how it is out of control and what happens next... #SPCtips

SPC tips No 13 The SPC chart now has the Upper Control Limit (UCL) in place. UCL calculated as the CL + 3 times the square root of the CL. This chart is currently in statistical control. #SPCtips

Rutin berolahraga ternyata dapat membuat tubuh tidak mudah terserang penyakit. Yuk mulai rutinitas menyehatkan ini setiap weekend #SPCTips

Comparing the proportions in two populations – with binary outcome. This popular article shows you how to do it — and why it matters. Check it out: spcforexcel.com/knowledge/comp… #ComparingTwoProportions #SPCforExcelSoftware #SPCTips #DataAnalysis #SixSigma