Runcharts 101 Geoff Schierbeck Quality Leader Surgery BCPSQC.

Runcharts 101

Geoff SchierbeckQuality Leader SurgeryBCPSQC

A Simple Run Chart: Building Block of Measurement for Improvement

Data displayed in time order

Data is collected and displayed weekly or monthly.

Run Charts can tell us what is happening in real time.

The Value of Data in Real Time

Why not before and after?

Adapted from Health Care Data Guide, p. 16 Figure 1.5 and 1.6 , Provost and Murray, 2011. San Francisco: Jossey Boss

Scenario 1

Adapted from Health Care Data Guide, p. 16 Figure 1.5 and 1.6 , Provost and Murray, 2011. San Francisco: Jossey Boss

Scenario 2

Adapted from Health Care Data Guide, p. 16 Figure 1.5 and 1.6 , Provost and Murray, 2011. San Francisco: Jossey Boss

Scenario 3

Adapted from Health Care Data Guide, p. 16 Figure 1.5 and 1.6 , Provost and Murray, 2011. San Francisco: Jossey Boss

Scenario 4

change made between week 7 and 8

Adapted from Health Care Data Guide, p. 16 Figure 1.5 and 1.6 , Provost and Murray, 2011. San Francisco: Jossey Boss

Run Chart

Control Chart

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Displaying Key Measures over Time - Run Chart

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-Data displayed in time order

-Time is along X axis

-Result along Y axis

-Centre line = median

-One “dot” = one sample of data

-Sample size = each “dot” should have the same n 0

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Perc

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Process: Cardiac Surgical Patients with Controlled Post-operative Serum Glucose

Showing improvement:

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No improvement. Random fluctuation.

Improvement. Trend going up.

Making the Run Chart in Excel

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1. Data will be in two columns. Column A will have dates or times, and Column B will have the result of your data collection.

2. Highlight this data

3. With your mouse, choose Insert -- Line -- Line With Markers

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Making the Run Chart in Excel

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Making the Run Chart in Excel - adding the median line

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4. Inserting the Median Line (needed to analyze the run chart): Calculate the Median Value from your Data

Making the Run Chart in Excel – adding the median line

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5. Enter the Median in Column C (we want a flat line for the median, i.e. all the same value)

8. The Run Chart is done and can be formatted: titles, gridlines, etc.

Note – to make the median a flat line with no markers, right click on the line and change the Marker Options.

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How Do We Analyze a Run Chart?

• Visual analysis first• If pattern is not clear, then apply probability based rules

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Non-Random Signals on Run Charts

A Shift: 6 or more

An astronomical data point

Too many or too few runs

A Trend5 or more

The Data Guide, p 78

Evidence of a non-random signal if one or more of the circumstances depicted by these four rules are on the run chart. The first three rules are violations of random patterns and are based on a probability of less than 5% chance of occurring just by chance with no change.

Data Display Principles

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*hypothetical data – illustrative purposes only

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Readmission Rate

Large Teaching Hospitals

Large Community Hosptials

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SMALL MULTIPLES – all info on one page

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ProvincialReadmission Rate

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*hypothetical data – illustrative purposes only