6/26/2013 Basic Tools for Data Analysis Michael D. Chance MSM, MBA, MSQM, CPHQ, CQIA, CSSGB Objectives 1. Define data. 2. Explain some barriers to successfully using data. 3. Explain the purpose and use of select quality data tools Explain common misconceptions and 4. limitations that arise from reporting “averages” or from relying on a single tool. Page 1 xxx00.#####.ppt 6/26/2013 1:42:18 PM What is Data? Data is: Factual information used as a basis for reasoning, discussion, or calculation. Page 2 xxx00.#####.ppt 6/26/2013 1:42:18 PM 1
6/26/2013 What Things are Considered Data? • Medications Given (Dosages, Routes, etc.) • Vital Signs / Symptoms • Patient Characteristics (Age, Sex, Race, etc) • Costs • Therapies • Staff Turnover, Working Hours, Ratios • Times (Admission, Discharge, etc.) • Anything we can document to measure performance. Page 3 xxx00.#####.ppt 6/26/2013 1:42:19 PM “We measure performance in healthcare for two basic purposes. We measure first as a basis for making judgments and decisions… Second, we measure as the basis for future improvements” Dennis O’Leary Former President, JCAHO Page 4 xxx00.#####.ppt 6/26/2013 1:42:19 PM Barriers To Putting Data Into Action • Don’t even know where to get data / info • Paralysis by analysis • No one is interested in it • Incorrect interpretation of data • Too complex to understand • Defensiveness Page 5 xxx00.#####.ppt 6/26/2013 1:42:19 PM 2
6/26/2013 Stages of Coping with Data • Stage I : “The data are wrong….” • Stage II : “The data are right, but it’s not a problem…” • Stage III : “The data are right, it’s a problem, but it’s not my problem…” • Stage IV : “The data are right, it’s a problem, it’s my problem…” Page 6 xxx00.#####.ppt 6/26/2013 1:42:19 PM How Do We Make Sense of Data? Page 7 xxx00.#####.ppt 6/26/2013 1:42:19 PM Quality Improvement Tools “If the only tool you have is a hammer, you will see every problem as a nail.” Abraham Maslow, 1966 Page 8 xxx00.#####.ppt 6/26/2013 1:42:19 PM 3
6/26/2013 Purpose of QI Tools • Describe and improve processes • Evaluate process or output variation • Assist with decision-making • Analyze data in a variety of ways • Display information Page 9 xxx00.#####.ppt 6/26/2013 1:42:19 PM QI Tools Help Answer 5 Questions 1. Where am I at? 2. Where do I want to be? 3. How do I get there? 4. Am I still on the right path? 5. How well did I do? Page 10 xxx00.#####.ppt 6/26/2013 1:42:19 PM Partial List of QI Tools Affinity diagram Kano model Arrow diagram Matrix diagram Balanced scorecard Mistake-proofing Benchmarking Multivoting Box and whisker plot Nine windows Brainstorming Nominal group technique Cause-and-effect/Ishikawa/fishbone diagram Pareto chart Cause analysis tools Plan-do-check-act (PDCA) cycle or plan-do-study-act Check sheet (PDSA) cycle Control chart Problem concentration diagram Critical incident Process analysis tools Data collection and analysis tools Process decision program chart (PDPC) Decision matrix Project planning and implementation tools Design of experiments (DOE) Quality function deployment (QFD) Evaluation and decision-making tools Relations diagram Failure mode effects analysis (FMEA) Scatter diagram Fishbone/Ishikawa/cause-and-effect diagram Seven basic quality tools Five S (5S) Seven new management and planning tools Five whys and five hows SIPOC+CM diagram Flowchart SMART matrix Force field analysis Spaghetti diagram Gage repeatability Stratification Gantt chart Success and effect diagram Histogram Survey House of quality Tree diagram Idea creation tools Value stream mapping Impact effort matrix Voice of the customer table (VOCT) Page 11 xxx00.#####.ppt 6/26/2013 1:42:19 PM 4
6/26/2013 Purpose of QI Tools However, you don’t have to use EVERY tool for every problem. Page 12 xxx00.#####.ppt 6/26/2013 1:42:19 PM Basic Decision Making Toolbox Histogram Pareto Chart Scatter Diagram Run Chart Control Chart Page 13 xxx00.#####.ppt 6/26/2013 1:42:19 PM Basic Decision Making Tools • Bar Charts Page 14 xxx00.#####.ppt 6/26/2013 1:42:19 PM 5
6/26/2013 Histograms • A bar graph that shows the distribution of CONTINUOUS data • A snapshot of data taken from a process • Summarize large data sets graphically Compare process results to specification • • Communicate information to the team • Assist in decision making Page 15 xxx00.#####.ppt 6/26/2013 1:42:19 PM Histogram Creation Check Sheet: Range No. of Occurrences 1 – 10 11 – 20 21 – 30 31 – 40 41 – 50 51 – 60 61 – 70 71 – 80 81 – 90 91+ Page 16 xxx00.#####.ppt 6/26/2013 1:42:19 PM Histogram Creation Histogram: Page 17 xxx00.#####.ppt 6/26/2013 1:42:19 PM 6
6/26/2013 Histogram Analysis Descriptive Statistics: Variable N Mean St Dev Minimum Median Maximum Absorption Time 100 30.009 5.002 13.759 30.694 42.076 Mean (or Average): Histogram of Absorption Time 20 X 30 15 Frequency Standard Deviation: 10 5 5 0 20 24 28 32 36 40 Absorption Time Page 18 xxx00.#####.ppt 6/26/2013 1:42:19 PM Histogram Analysis • Histograms are a 25 20 snapshot in time and 15 10 show “distribution”. 5 0 • They do NOT show 25 20 trends over time. 15 10 5 7 0 6 5 25 4 20 3 15 2 10 1 5 0 0 Page 19 xxx00.#####.ppt 6/26/2013 1:42:19 PM Basic Decision Making Tools • Pareto Chart Page 20 xxx00.#####.ppt 6/26/2013 1:42:19 PM 7
6/26/2013 What is a Pareto Chart? • Bar chart arranged in Budget Allocation descending order of height from left to right 100 • Bars on left relatively more 80 Thousands important than those on 80 right 60 • Separates the "vital few" 38 40 27 from the "useful many" 14 11 20 5 (Pareto Principle) 0 • 80/20 Rule Code 20 Code 10 Code 50 Code 30 Code 40 Code 60 -80% of the gain from 20% of the categories Page 21 xxx00.#####.ppt 6/26/2013 1:42:19 PM Why use a Pareto Chart? • Breaks big problems into smaller pieces • Displays causes or problems in priority order • Identifies most significant factors • Shows where to focus efforts • Allows better use of limited resources Page 22 xxx00.#####.ppt 6/26/2013 1:42:19 PM Case Study Overall Rating 100% 95% 90% Where do we start? 85% 80% 75% 1-24 2-7 2-21 3-6 3-20 4-3 4-15 4-30 5-15 5-30 YTD Goal Satisfaction Page 23 xxx00.#####.ppt 6/26/2013 1:42:19 PM 8
6/26/2013 Example - Pareto Chart Delay: 27 Communication: 15 N = 122 Procedural / Competency Issues: 15 Staff Issues: 13 Environment – Cold: 12 Documentation/Admin/Billing: 11 Appointments: 7 Entertainment: 4 Location: 4 Parking: 4 Gown Size: 3 Other: 7 Page 24 xxx00.#####.ppt 6/26/2013 1:42:19 PM Example - Pareto Chart N = 122 30 100% 100% 27 94% 92% 90% 88% 85% 25 82% 80% 76% 70% 20 67% 60% 57% 15 15 15 13 50% 47% 12 11 40% 10 34% 7 7 30% 22% 20% 4 4 4 5 3 10% 0 0% Delay Comm Proc/Comp Staff Environ Admin Appt Entertain Location Parking Gown Other Complaints Cumulative Page 25 xxx00.#####.ppt 6/26/2013 1:42:19 PM Example - Pareto Chart N = 122 30 100% Break point 100% 27 94% 92% 90% 88% 25 85% 82% 80% 76% 70% 20 67% 60% 57% 15 15 15 50% 13 47% 12 11 40% 10 34% 7 7 30% 22% 20% 4 4 4 5 3 10% 0 0% Delay Comm Proc/Comp Staff Environ Admin Appt Entertain Location Parking Gown Other Complaints Cumulative Page 26 xxx00.#####.ppt 6/26/2013 1:42:19 PM 9
6/26/2013 Basic Decision Making Tools • Scatter Diagram Page 27 xxx00.#####.ppt 6/26/2013 1:42:19 PM Scatter Diagrams A graph of paired data points plotted on a table that helps identify the possible relationship between the changes observed in two different sets of variables. Page 28 xxx00.#####.ppt 6/26/2013 1:42:19 PM Why use Scatter Diagrams? • Supplies the data to confirm a hypothesis that two variables are related. • Provides both a visual and statistical means to test the strength of a potential relationship. • Provides a good follow-up to a Cause and Effect Diagram to find out if there is more than just a consensus connection between causes and the effect. Page 29 xxx00.#####.ppt 6/26/2013 1:42:19 PM 10
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