Improvement of Risk – Adjusted Cumulative Sum (CUSUM) Charting Procedure for Observing the Quality of Hospital Service
Introduction
Hospitals across the country are searching for ways to improve quality of care and promote effective quality improvement strategies. With the growing emphasis and concerns on quality of hospital services, performance monitoring of care providers has received much concentration recently. Performance measures used as monitors are typically clinical outcomes, utilization of health services, and cost. By monitoring these measures continuously, changes in the performance of care providers can be detected swiftly to avoid serious consequences as well as provide valuable information on the care delivery system for quality improvement. One critical challenge in performance monitoring in medical contexts is the need to adjust for patient case mix, called risk adjustment (Iezzoni 1997). Unlike products in manufacturing processes which are moderately homogeneous in nature, quality of hospital service vary a lot in their characteristics or risk factors, which may affect the performance monitors. Performance monitoring with such considerations is referred to as risk-adjusted (RA) monitoring in the literature.
Risk-adjusted process control charting procedures for observing the quality of hospital service are proposed as quality management tools. In Statistical Process Control (SPC), the Shewhart charts are not as good at identifying trends and detecting smaller shifts in the process. In order to improve the detection capability relation to that of the Shewhart control charts, several …show more content…
Methodology
• Carry out an extensive literature review on the Risk-Adjusted CUSUM charting procedure.
• Develop the improved version of Risk-Adjusted CUSUM charting procedures.
• Test the model for real data.
• Develop an application guide line.
Resource requirements: MINITAB, SAS and R Software. (These are available in the Department of Mathematical
Introduction
Hospitals across the country are searching for ways to improve quality of care and promote effective quality improvement strategies. With the growing emphasis and concerns on quality of hospital services, performance monitoring of care providers has received much concentration recently. Performance measures used as monitors are typically clinical outcomes, utilization of health services, and cost. By monitoring these measures continuously, changes in the performance of care providers can be detected swiftly to avoid serious consequences as well as provide valuable information on the care delivery system for quality improvement. One critical challenge in performance monitoring in medical contexts is the need to adjust for patient case mix, called risk adjustment (Iezzoni 1997). Unlike products in manufacturing processes which are moderately homogeneous in nature, quality of hospital service vary a lot in their characteristics or risk factors, which may affect the performance monitors. Performance monitoring with such considerations is referred to as risk-adjusted (RA) monitoring in the literature.
Risk-adjusted process control charting procedures for observing the quality of hospital service are proposed as quality management tools. In Statistical Process Control (SPC), the Shewhart charts are not as good at identifying trends and detecting smaller shifts in the process. In order to improve the detection capability relation to that of the Shewhart control charts, several …show more content…
Methodology
• Carry out an extensive literature review on the Risk-Adjusted CUSUM charting procedure.
• Develop the improved version of Risk-Adjusted CUSUM charting procedures.
• Test the model for real data.
• Develop an application guide line.
Resource requirements: MINITAB, SAS and R Software. (These are available in the Department of Mathematical