title: False alarms in surgical quality control.
abstract: Streakiness in performance is a well-known phenomenon. The theoretical adverse effect of such runs of outcomes on standard statistical process control tools is widely known--resulting in an increased rate of "false alarms." Should healthcare managers view this effect as an important practical concern for quality management? This article investigates cardiac surgery outcomes in Florida for more than 200 high-volume surgeons. The results confirm the presence of statistically persuasive streakiness in performance for an unexpectedly high number of surgeons. Also, cumulative sum charts may be more useful than the standard Shewhart process control charts to analyze this type of data.
authors.affiliation: mhuesch@anderson.ucla.edu
authors.forename: Marco D
authors.initials: MD
authors.lastname: Huesch
mesh_terms: D005431:Florida; D013502:General Surgery / Q000592:standards*; D006801:Humans; D008499:Medical Records / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods*