INFORMATION MANAGEMENT

2 definitions are important to understand IM:

1-Data: The collection of uninterrupted observations or facts.

y
2-Information: is what happened when data are aggregated together, analyzed

bh
and interpreted into a form, useful for decision making.

So
&allow the user to understand the severity of issue &what action to be taken.

&The Goal of IM: is to utilize data to support decision making to improve

a
process and patient outcomes.
m
es
IM Process:
N

 Identify data (assessment) plan the information management

r/

Structure  collect data analyse & interpret.

D

Decision making process (IM Cycle):

Strategy for interpretation and utilization of information

1- Planning & organizing for data collection.

2- Data verification and correction.
3- Potentially important findings identification.
4- Further study &development of recommendations for change.
 5- Taking actions & report decisions.
6- Monitoring performance.
7- Communication of results.

Basic concepts related to IM:

y
bh
1- Data should be defined, collected, analysed before being used in quality
management.

So
2- Not all data are useful in QM (DRIP) data rich but information poor.
3- Focus on information related to patterns of care not individual care.

a
4- Process should be monitored as well as outcomes.
m
5- Cost & quality are inseparable issues.
es

Information Resources :
N

Internal external
r/

Inpatient records Accreditation reports

D

QM summaries Identified benchmark(best

practices)
Patient surveys/interviews Reference databases
Indexes, registers
Adv: Adv:
1- Ready for analysis & use as Make it earytobenchemark other
soon as it is collected. facilities who submitted same
2- Best used when there is desired
adv
change to the process.
 Disadvantages : Disadvantages :
1- May not be correct 1- Not available in timeline.
2- not reliable. 2- For diff organization data
definitions are not the same
3- Old and infrequently updated.

y
4- Cannot be used when a desired

bh
change is needed .

So
a
m
&TYPES OF INFORMATION AVAILABLE
es
N
r/
D

Data collection methods ( Tools ):

‫الزم اسال نفسي‬What are you trying to measure  then keep tool as short
&simple as possible ,include all data element you want to measure.

Data sheets work Check sheets

Surveys&questionnaire Focus group
sheets /tally sheets
Extracting data Useful when To get feedback from a *6-12 Participants with
from medical record counting large group common interest
on paper something to see Advantages : *visually or audio
how often it For assessment of recorded
occurs customer need *coordinator
Disadvantages: Disadvantages: expectation &satisfaction Disadvantages:
Risk of data entry limited Disadvantages: expensive
error Details , so limited *Limits data analysis time consuming
analysis can be *Low level of response , limited analysis but
done on it. so cannot be generalized. very valuable.

y
bh
Language

So
Collection Principles Concepts:

a
Organizational leader identify (interdisciplinary quality team) & (cross
functional team)
m
es
1-to maximize
 Use of collected data
N

 Data collect effort conduct

 Organization comforter capitalist
r/

2-to minimize
D

 Effort duplicated

Data collection continuum

 Automatic or manual or hybrid of both.

Data Collection Process

1-Coordinate data collection
 Determine the purpose
 define the population of interest.
 How it would be measured (Nominator &Denominator)
 Define the appropriate tool.
 How to display
 Determine the sampling method, and collect a baseline sample ( pilot ) to
determine the usefulness of the collection tool.
 The person who will collect data should be trained and assessed using
inter- rater reliability
 2-Validate data integrated
 Data must be organized - Validated – analyzed
 Validation first data collection of small sample, then second
collection should yield the same results  if the same , so valid
  if not the same, increase the sample and do it again.

y
bh
3- Using excel to validate data collected

So
Index vs. Register
a
m
Index Registers
es

Permanent topical collections of medical record data permanent chronological

N

required by state laws and logic to locate cases for record listings for maintaining certain
maintenance, statistics and research ‫فيها اهن الوعلىهات‬ statistics, patients are possibly
r/

separated to
Examples: inpatients, outpatients, and
D

Emergency patients ‫فيها كل‬

•Master Patient Index (MPI):A permanent file of all ‫الوعلىهات‬
patients seen in the organization, with dates, names of
attending physicians, and medical record numbers Examples:
(generally considered the most accurate index of patient
information )  Deaths
 Births
•Physician Index:A file of cases attended by individual  Deliveries
physicians, maintained for a minimum of 10 years .  Surgical log
 Emergency
•Disease Index: A file of principal diagnosis codes with  Cancer
individual patient information, maintained at least 10
 medical Device
years. (mandatory under FDA)
•Surgery Index: A file of principal procedures similar to
the Diagnosis Index.
 Confidentiality of patient information
What is a confidential information?
It is the information that one entrusts to another with the understanding that it
will be kept private and not shared.

y
bh
Protected information: information that can’t be obtained by others or used in a
court of law which is protected &cannot be disclosed without the consent of the
client (privileged communicated)

So
HIPAA: Health Insurance Probability And Accountability Act
The HIPAA "minimum necessary" rule means that, access to "protected health

a
information" (PHI) is to be limited to those persons or classes of persons who
m
have a need to know in order to carry out their roles ,the patient is considered
es
the "owner" of the information in the U.S and can access and copy that
information by signing in a release form.
N

Informed Consent: a rational, informed decision from the patient or legal

representative to permit medical-surgical treatment.
r/

& if not done  this is a Medical error called "battery".

D

A valid written consent must contain

1- Exact name of the procedure
2- The consenters under standing of : the nature of the procedure , the
alternatives , risks and benefits involved , probable consequences of non
treatment , date of consent , witness.

Two types of consent forms should be obtained:

❖ General
A general admission or treatment consent, as applicable (information provided
by the organization, but not necessarily by the practitioner.
❖ Special
A special consent form for highly technical testing, medical, or surgical
treatment (information provided by the practitioner).
 THE MEDICAL RECORD
The primary legal document, as well as the primary data source (either
electronic or paper) for recording and ascertaining the quality of healthcare
delivery to patients.
Purpose of medical record

y
1- Continuity of care (by another practitioners)

bh
2- Communication among practitioners.
3- Legal protection

So
4- Data, information source
5- Patient identity
6- Diagnosis support &justification
7-
a
Documents of the course and results
m
8- Determine the reimbursement rate and justification of claims.
es

THE MEDICAL RECORD REVIEW

N

It is a screening process :
r/

can be done by non-physician , called primary review or primary

analysis or ongoing analysis .
D

If primary screening has shown any trends intensive analysis should be

done by peer review or focused review .
Types of medical record review
 concurrent review: during hospitalization
 retrospective: after discharge ( or death)
 prospective: for assessing treatment approval.

Medical record Delinquency: is no incomplete medical records, a record is said

to be completed when it is content reflect pt conduct of final diagnosis.
M R delinquency rate = no of delinquent MR /average monthly discharge
These many include policies for documentation issues :
Abbreviate use ,verbal order, MR retention &destruction , security of electronic
patient information.
Management information systems
It is the sum of all manual and/or automated systems. designed to clinical
information system administration support decision-making. Analysis to provide
&coordinate information to be used in the management decision-making and
administration of organization.

y
What is the quality objective from it :

bh
1-To help decision-making process.

So
2-communicate among all functions.
3-Improve data accuracy
4-privacy , accuracy and security of data.

a
m
An integrated electronic information system that links all activities such as
quality, utilization and risk management with patient clinical and financial
es
database (this is the quality goal)
What key element must be in MIS :
N

1- present performance &future computer needs of the organization wide

r/

quality strategy.
D

2- The ability of program to integrate all organization function and data base
3- flexibility of using program
4- level of computer knowledge training of staff
5- cost/effectiveness analysis
6- timely upgrade

How to select software support QM /PI

1- commitment from leaders to the evaluation process(should be strategic
initiative)
2-select a team, represent various organization hard-soft ware users.
3-assess needs & system requirements.
4-evaluate potential vendors for satisfactory performance with other
organizations , product history ,implementation ,maintenance and upgrade
5-comparison of each product against requirements.
6-negotiate a contract.
EPIDEMIOLOGICAL THEORY AND METHODS
• The branch of medicine [and public health] that investigates the causes and
control of epidemics (prevalent and rapid-spreading, human contagious disease)
Risk Factors: elements associated with increased danger of developing disease.

y
Causality: the interrelationship of cause and effect, it is means that nothing can

bh
exist or happen without cause.
When there is a strong relation between risk factors and the outcome, so there is

So
causal relationship.
To say there is a causal relationship in epidemiology , it requires:

a
1- Biological plausibility must exist ( method establish causal relationship
m
between a biological factor and a particular disease )
es
2- Risk factor "exposure" must precede the outcome
• Types of causal association include:
N

1) Single cause with a single effect

2) Multiple causes with a single effect
r/

3) Multiple causes with multiple effects

D

Numerator and Denominator

• Numerator :The number (in a population) with a disease, condition, or events.
• Denominator : Either the number of the whole population in the same place at
the same time (proportion) or a comparable population (ratio)

Frequency Comparisons

proportion: part to whole relation ship

Decline – part/whole 5/10=0.5
Percentage -part/ whole x100 5/10x100=5%
Ratio: relationship between two proportions not part to whole 9:8 2:1
Rate:A quantified (numerical) comparison of the frequency of events in one
population (numerator) with the frequency of the same events in a comparable
but different population (denominator) in a specified time period.
Morbidity: The rate of disease or proportion of diseased persons in a given
locality, nation,

y
health system.

bh
Incidence: Rate of new cases during a specified time period. e.g: new cases
during 1 year period ( no of new cases that develop in a given period of time )

So
New cases of transfusion reaction in year 2018 / total no of patients receiving
blood in year 2018

a
Prevalence: no of all cases of a disease that are present in a particular
m
population at a single point of time ( point prevalence ) or over a period of time (
period prevalence )in a given population )
es
Point prevalence = (Old cases + new cases) at one point in time / number of
persons in the population at the same point in time
N

Period prevalence = ( old cases + new cases ) over a defined period of time /
r/

number of persons in the population over the same period.

D

Mortality Rate:
The proportion of deaths in a population within a time range.
= no of deaths / total population

Data Definitions and Collection

Sensitivity: The ability of a measure, test, or tool (study design, screening tool,
or lab test) to identify and select all positive cases or specified variations or
deviations.
Sensitivity=TP/TP+FN = true positive / ( true positive + false negative )
Specificity: The ability of a measure, test, or tool to exclude
all negative cases.
Specificity=TP/TP+FP = true negative / ( true negative + false positive )
Stratification: The classification of data into homogeneous groups or
subsets.
e.g., the study of UTI by organism; by catheterization, by surgical procedure, by
nursing unit.
Recordability: ability to identify, capture & measure needed information

y
bh
Validity: ‫الصالحيه‬The capability of the indicator or collection tool to measure
what it is supposed to measure

So
Reliability:‫ الذقه في االداء‬The ability of the indicator or collection tool to
measure in a reproducible way what it is supposed to measure (" interrater
reliability").

a
m
Usability:‫ سهىله االستخذام‬The relative ease with which the indicator can be
understood or the tool can be used.
es
Other definitions
N

Goal: a numerical value that defines the significance level of the data that is
desired for decision making
r/

Trigger: a numerical point at which there should be some action taken

D

=stimulation of an action= a must response

Threshold: a numerical point below which the data shouldn’t fall or it is the
point at which something begins.
Bench mark: a standard against which data may be compared or assessed
(best practice)

Genreal data collection methodolgy

1-Data collection tools: Discussed before
2-Time frames:
Prospective: Data collection occurs prior to care.
Example: before the patient is accepted in the hospital ,the needed care is within
the hospital scope or not.
Retrospective: data collection after care is being rendered
Example : mortality rate
Concurrent : data collection while care is being rendered
Example : surgical care improvement project ‫يوكن تعذيلها اثناء البروسيس‬

y
Focused: data collection occurs when only certain topics are the focus of data

bh
collection.
Intensive data collection , so the Highest prices &need resources

So
Population &sampling
Population:100% of the possible group to be studied (individuals, objects,
Events) 2 types(static or dynamic).
a
m
Sample :a subset of a population or a group drawn from a larger population.
es
The purpose of sampling:
N

To measure only a portion of the whole in order to achieve accurate

representation of the entire population &then generalize the results to the whole
r/

Factors to consider:
D

1-the sample must represent the characteristics of the population.

2-The location and time period from which the sample is to be drawn must be
considered.

Sampling techniques

Probability sampling:
High probability that findings can be generalized to the whole population.
Non probability sampling:
Low probability that findings can be generalized to the whole population.
TYPES OF PROPABILITY SAMPLING TECHNIQUES
(RANDOM SAMPLING)

y
1) Simple Random

bh
Uses a table of random digits (available in all statistical software) to

So
select the case from a list every case in 1 population
( Each case has an equal chance of being selected)

a
2) Stratified simple Random m
Sampling utilizes 2 or more homogenous categories ( strata ) of a
es
population, then choose one of each category randomly. ‫بنقسم األشخاص‬
‫لمجموعتين أو أكثر ثم نختار عشوائي من كل مجموعة‬
N

3) Systematic Random
r/

utilizes a system to select the sample, the first to be choosen randomly.

D

Example: Every 5th or 3rd case

4) Cluster sampling ( HQ Solutions )

Requires that the population be divided in to groups , or clusters , then one

cluster to be chosen randomly.

TYPES OF NON-PROPABILITY SAMPLING TECHNIGUES:

(NON-RANDOMIZED SAMPLING)

1) Convenience
Sampling utilizes data that is most readily available ‫الداتاالمتاحةوالسهلة‬
Selection bias , so may not reflect whole population
 2) Quota
Sampling utilizes portions or percentages of persons in a stratified
population , the researcher identifies the strata according to his

y
certain criteria, and he determines the proportion needed from

bh
each strata.
3) Purposive( judgment )

So
Sampling selects persons because they demonstrate a desired
characteristics.

a
m
4) Expert Sampling :
es
N

MEASUREMENTS
r/
D

Data basics

Type Categorical Data Continuous Data

Other Names Qualitative
=Discreptive=Attribute
=non parametric
Explanation Categorized and can be
counted, but no decimals
Sub Type 1)Nominal (no ranking)
Examples Yes or No Questions,
Quantitative = Numerical=
Variable=parametric
Measured on continuous
scale rather than discrete
1)Discrete=Interval
(ranking))no decimal)
No absolute zero
difference between
measurements is meaningful
Dice, number of hepatitis
 colors, gender, names, patients in hospital, number
religion, births, of caesarian sections
occurrences, procedures
Sub Type 2)Ordinal (ranking) 2)Continuous=Ratio(decimal)

y
zero is absolute value

bh
zero is benchmark

So
Examples Race, satisfaction Weight, height, time, length
degree(v.satisfied- of stay ,Ratio ,Age , Charges
satisfied -neutral-un

a
m
satisfied -v. un satisfied)
es
Statstical Test % in each category Mean, Mode, Median, Max
CHI SQUARE test percentile
N

T.Test
r/

Display tools Table, Score Card, Bar Histogram, Run Chart,

D

Chart, Pareto Control Chart

Data types ( In-Brief )

Qualitative Quantitative
= attribute =categorical = numerical ‫عدديه‬
‫مقسمه الي كاتيجوريز اما‬
Nominal or Ordinal discrete continuous
Yes/No by orders ( interval ) (ratio )
( mode ) ( mode / median ) ( mode / mean / median)
( 2 samples or more use chi square ) *2 different sample , T-Test
*1 sample before and after,Paired T- Test,
*if >2 samples  ANOVA
 Statistical Thinking:
understands and views work as a process and recognizes that the process and
the measurement data they produce will exhibit variation and the variation
should be appropriately responded to reduce the variation to increase quality.

y
A process is in good statistical control When:

bh
1) Stable over time (demonstrate through measurement data).

So
2) Operated in a stable, consistent matter with no arbitrary changes in
process steps or conditions.

a
3) The process aim is set and maintained at the proper level based on
m
quality specification and target values.
es
4) The average or normal process variations (control limit) falls within the
specification limits.
N
r/

Basics Statistics:
D

Descriptive Statistics:
Data type Distribution Central Tendency Variability
Nominal µ, percentage Mode
Ordinal µ, percentage Median, Mode Range,min/ max
Interval\Ratio Mode,Median,Mean Range, min/max,
SD, variance

Central Tendency:
Describes a set of measures that indicates what is the middle value.

1-MEAN= Average=
For Continuous data
Used with: interval and ratio types of data
When Astronomical value or outliner data (the value is very different from
remaining values ex. 1, 3, 5, 60) So, the mean is pulled toward astronomical

y
value. So, if data skewed, we use Median instead of Mean.

bh
Disadvantages: doesn’t really indicate the middle of data

So
2-MEDIAN

a
The middle value in the list of numbers ( represents a location)
m
Used with: Ordinal, Interval / ratio data types.
es

MEDIAN location = But First we should RANK the values.

N

IF the middle number is single number so it is the median1,2,3,4,5,6,7

r/

IF the middle numbers are 2 numbers so we will calculate the mean:

D

1,2,3,4,5,6 mean= =3.5

Example: Pain Scale
Advantage: Median doesn’t affect by astronomical or outliner values

3-MODE
Is the most Frequent appearing number
Used with: Nominal, Ordinal, Interval, Ratio data
Like: Yes or No questions, Percentage, Proportion
Example: 29, 56, 109, 110, 360 > No mode
NOTES:
1) If normal distribution curve: Mode=Median=Mean.
 2) If asymmetrical (skewed distribution): Mode in highest point.
and Mean toward the tail and Median between Mode and Median
So, it is better to utilize Median.
3) If there are repeated samples of the same types.

y
Mean is more stable value from sample to sample.

bh
Mode is the least consistent value.
Weighted Mean = Weight*Mean

So
To calculate total performance score using weighted mean

Total performance score= =

a
m
DISPERSION OF DATA:
es

Refers to how variable, scattered or spread of the data in a distribution

N

1-RANGE:
r/

The difference between the highest and lowest numbers in a set, but it doesn’t
D

tell anything about in between values

Ex. 1, 2, 3, 4, 10 > Range = 10-1=9

2-FREQUENCY DISTRIBUTION:
A logic and systematic arrangement (Rank Ordering) of numerical values from
the highest to lowest or from the lowest to the highest
There are 4 types of frequency distribution
Simple Frequency distribution Grouped Frequency distribution
125 5 Scores frequency
124 3 100-150 2
123 2 151-200 4

y
N=10 201-250 3

bh
‫بيشوف كل رقم من دول اتكرر كام مره و‬ i=interval=50, N=2+4+3=9
‫بعدين يجمع التكررات و مجموعها يساوي عدد‬ ‫للتسهيل في حاله االرقام الكتيره لكن نفس فكره‬

So
‫العينه‬ ‫اللي قبلها‬
Cumulative Frequency distribution Relative Frequency distribution

a
Calculated like grouped frequency
m Proportion calculation of percentage
then add the value of data to all to whole relationship
es

smaller points
N

Scores frequency cumulative

r/

100-150 2 2
D

151-200 4 (2+4)=6
201-250 3 (3+4+2)=9
N=2+6+9=17

3- RATIO Or Proportion
A Fixed relation in number or degree between 2 similar things
Ex) calculation of the difference between 2 ratios

and we will multiply first ratio *5

and so the difference is 250-200=50

4-STANDARD DEVIATION
A computed value describing the amount of variability in a particular
distribution
It is the square root of variance

y
σ=SD=√

bh
Variance: is the arrhythmic mean of the squared difference between each

So
value and mean value
Normal distibution bell curve

a
m
es
N
r/
D

Parametric and Non-parametric tests

Parametric tests Non-parametric tests
Assume normal distribution of data Parameters are not estimated less
(continuous) are powerful in data concern about actual distribution
description useful in large sample best when data not interval and not
size ratio
Useful in large sample size Useful in small sample size
Used in: Interval and Ratio data type Used in: Nominal and Ordinal data
(continuous data) type (categorical data)
If 2 group>T.Test If 2 group or More> Chi Square
If more than 2 group> ANOVA
T.Test: used to compare 2 groups on
the same measured variable using
MEAN of each group to see if they

y
indicate real (significant) difference

bh
So
How To Choose A Hypothetical Testing ? ( in – brief )
Any numerical data ( interval / ratio ) which I can calculate a mean from  T –
test or ANOVA according to number of samples

a
If you couldn’t calculate a mean ) Nominal / Ordinal ) data  Chi –Square Test
m
Both Chi Square and T.Test has P-Value
es

P-Value: is a number between (0-1)

N

If P-Value is less than 0.05  So, there is statistically significant difference

If P-Value is More than 0.05  So, there is No statistical significant difference
r/
D

TYPES OF ERRORS:

Type Ⅰ Error (α Error) Type Ⅱ Error (β Error)

Assume there is a relationship Assume there is no relationship
between 2 variables when in fact between 2 variables when in fact
there is no relationship there is a relationship
False positive results  incorrectly False negative results  failure to
reject null hypothesis reject null hypothesis
The worst and should be avoided Ex) one assumes that green tea
Ex) drug A is increasing cardiac doesn’t affect weight gain
output
Tests of significance :
H0 Null hypothesis ( claim or truth ) means no difference between
groups
Example : New antihypertensive drug / a placebo  null assumes no

y
bh
difference
Ha Alternative hypothesis ( assumes there is a difference )

So
P-VALUE Assumes null is true , it is the probability of obtaining
results at least as the Null , so high P value means high probability

a
m
that the null is true , so the results fails to reject null hypothesis and
es
low P-value means acceptance of alternative hypothesis
The probability of making alpha error ( incorrectly reject null ) usually
N

5 % = ,05 ,SO
r/

IF P-Value <.05  results are statistically significant

D

Accept alternative hypothesis

IF P-Value >.05  results are statistically insignificant
Failure to reject null hypothesis

Regression Analysis:
Is a statistical technique that allows one to
compare

To measure correlation/ interrelation

CORRELATION COEFFICIENT (r)
The value computes in regression analysis that expresses the strength of the
relationship between 2 sets of measures
It expresses the degree to which the dots in a scatter diagram for

y
m a straight line.

bh
If r=+1 Strong positive relationship>> both increase or decrease together
If r=-1 Strong negative relationship>> one increase and another decrease

So
If r=zero>> No significant relationship = No linear relationship ( may be a
circulinear relationship or any other relationship)

a
The scatter diagrams
m
es
One way to display the possible relationship between 2 variables (2 sets of
data), looking at how closely they correlate
N

The Correlation may represent a possible cause and effect relationship

r/

Regression Equation:
D

The formula for the line that best fit dots of the scatter diagram
Can be used to predict the expected value of one variable based on values of
others
MULTIPLE REGRESSION ANALYSIS:
Similar to simple regression analysis but includes multiple independent values.
Interpercentile range: (Interquartile range)

y
bh
So
Refers to the data between the 1st quartile (25th percentile) and the 3rd quartile
(75th percentile) or, Sometimes describes the middle 50% (50th percentile) of

a
the data values
m
The most Commonly used IQR is in Baby Growth Chart
es
N
r/
D

Statistical Process Control

The use of measurements to study a process with the goal of making it perform
in a certain way, conform to standards, and continuously improve.
Walter Shewhart invented control chart ( shewhart chart ) to maintain
statistical process control and PDCA
Variation: is a change or deviation in form, condition, appearance, extent from
a former or usual state or form assumed standard (best practice, benchmark)
Human variations are more common than machine variations
Some variations are wasteful and harmful so, quality specialist should eliminate
variations
Variance: changing or tendency to change=degree of change or
difference=discrepancy=divergence

Process Variations

y
When to say that the process is statistically controlled process?

bh
When the process is

So
1) stable over time
2) operated in a stable consistent manner (reliable)

a
3) control limits fall within the expectations
m
But there are 2 types of process variations
es
Random or Common cause Assignable or Special cause
variation variation
N

Intrinsic to process itself Extrinsic to usual process

r/

Refers to situations usually in Related to identifiable patient or

D

systems that are more chronic, clinical characteristics or

ongoing and persistent.
More difficult to eliminate
More time consuming
idiosyncratic practice and other
tracked functions by RCA
Ex) sentential events
Out of the ordinary circumstances
One-time occurrence

Contributes to normal range Displayed by bell shape as outliers or

variations within the process tail
Goal to reduce (not eliminate) it to Goal to eliminate the cause focused
produce sustainability and stability or cause special review by RCA
(define, analyse, prevent)
 Key words are chronic, inlier, Key words are acute, unstable,
inherited, intrinsic, random, noise, outlier, assignable, extrinsic,
common identifiable

y
bh
Quality Improvement Tools

So
The appropriate display of information is a key responsibility of the quality
professional, So the decision of performance improvement will be made and it

a
will directly affect process effectiveness and outcome.
m
In every tool we should know answers of these following questions:
es

1) What is this tool? (in exam they may bring a display to recognize which
N

tool is it?)
r/

2) What it tells us? (you should interpret the graph)

D

3) When it is best utilized? (when to use it?)

> Identify a problem
> Data analysis
> Solution planning
> Outcome evaluation
 TOOLS

STATISTICAL TOOLS PROCESS TOOLS

(measurement) (improvement)
1) Tables 1) Check sheet

y
2) Pie chart 2) Brain storming

bh
3) Frequency plots 3) Task list

So
a) steam and leaf 4) Gantt chart
b) dot plot 5) Cause and effect diagram
c) Histogram
a 6) Affinity diagram
m
d) bar chart 7) Flow chart
es
e) pareto chart 8) Lotus diagram
N

4) Scatter diagram 9) Process map

5) Run chart 10) Value stream map
r/

6) Control chart 11) Delphi technique

D

12) Nominal technique

13) Force field analysis
14) Prioritization matrix
15) Multi voting

STATISTICAL TOOLS:

1) Tables
organized and summarized data for a sample, population, a given set of
criteria, screens.
It is not preferred to show it to leaders because It is hard to understand
Ex) infection control surveillance (statistics related to antibiotics)
 Specific measurement data
Ex) medication use, waiting times

y
bh
Identifying a problem

So
Outcome evaluation
2) Pie chart

a
A relative frequency (%) of the proportional relationship with a data set
m
Not frequently used unless if proportion it used
es
N
r/
D

3) Frequency plot
How often a value occurs and repeated
a graph designed to display the location, spread and shape of the data
a) steam and leaf
b) dot plot
c) Histogram
d) bar chart
e) pareto chart
A)stem and leaf plot ‫تقسماألعدادحسباآلحادوالعشرات‬
65,67,68,71,74,108,103,103 109,112,112,115,125,129

10 9 6 5,7,8

y
11 225 7 1,4

bh
10 8,3,3
12 59

So
B) DOT PLOT

a
A graph utilizes a dot for each unique value
m
es
N
r/
D

Graphs Dot plot or bar chart Histogram

Data type Qualitative (categorical) Quantitative (continuous)
Can be ranked from Disadvantage: Used in small
highest to lowest or from samples
lowest to highest values
to identify the problems in
pareto chart
C) HISTOGRAM

y
bh
A bar graph of the frequency of one continuous variable, x-axis is

So
independent variable and y-axis is dependent variable
Data analysis

a
Outcome evaluation
m
D) BAR CHART
es
N
r/
D

Display a categorical data, display in Comparison between different

groups or a collection of discrete objectives

and if ranked from highest to lowest we called it pareto chart and
commonly used in root cause analysis of sentinel events

E) PARETO CHART
 A special form of vertical bar chart with bars in rank order of occurrence
from highest to lowest.
Mainly used to Prioritization after comparison.
identify the problem

y
data analysis

bh
outcome evaluation
There are 3 types of pareto chart

So
1) simple pareto chart 2) advanced pareto chart 3) pareto drill down

a
4) Scatter diagram
m
es
Fof data analysis
outcome evaluation
N

5) Run Chart
r/
D

A running process record over time

(should be started to display the process as soon as possible if data is
avaliable, but should not analyze data until you complete 10 data point)
Can be used for any type of data, if the data displayed over time
usually it is based on median because the data used may be skewed, so I
can not put upper and lower contol limits like contol chart.
median=

Types of variations:
A) Common Cause Variations
is acceptable

y
quality department should monitor only because it is stable process or

bh
controlled process .

So
B) Special Cause Variations
if we have a special cause in run chart , so Next step is to do deep

a
analysis or root cause analysis or peer reviwe to investigate about the
m
special cause
es
identify the problem
data analysis
N

outcome evaluation
r/

Run Chart Rules for Interpretation

D

Rule One – A Shift

A shift on a run chart is six or more consecutive points either all above
or all below the median. Values that fall on the median do not add to nor
break a shift. Skip values that fall on the median and continue counting.
This rule is based on statistical probability.
Rule Two –A Trend
A trend on a run chart is five or more consecutive points all going up or
all going down. If the value of two or more successive points is the same,
ignore one of the points when counting. Like values do not make or

y
break a trend.

bh
So
a
m
es
N

Rule Three – Runs

r/

A run is a series of points in a row on one side of the median. A non-

D

random pattern or signal of change is indicated by too few or too many

runs or crossings of the median line.

Rule Four – Astronomical Point

This rule aids in detecting unusually large or small numbers. They are
characterised by data points that are obviously, or even blatantly
different from all or most of the other values, and anyone studying the
chart would agree that is unusual
6) Control Chart
It is another type of line graph after run chart but it has upper and lower
control limits and it usually utilizes mean in the middle (not median)

y
bh
So
a
m
es
N
r/

we have a special cause in control chart if

D

a)Shift > 8 points in a raw of the same side (upper or lower)

b)Trend >6 points increasing or decreasing
c)Astronomical values (out of A zone)
d) 14 points ups and downs
e) 2 points out of 3 points are in A zone
f) 4 points out of 4 points is above C zone
g) 15 points all are in C zone
H) 8 points and no one of them is in C zone
Process tools

Used in quality improvement and quality planning to

a) Generate ideas

y
b) Understand the process

bh
c) Peritorize improvement efforts

So
1) Brain Storming

To create many ideas in a short time, there are 3 types of brain storming

a
Structured
m
unstructured rapid
es

2) Nominal Group Technique (brain storming then ranking)

N

give everyone in a team an equal voice in brain storming, problem selection,

r/

resolution
D

- Ideas are clarified, but not criticized

- each idea rated then by each participant

3) Multi-voting

To priotorize a long list of alternatives to end up with the critical few ideas
upon with the team should focus
multi-voting is best done after Brainstorming

4) Delphi-technique

A tool used to reach team consensus concerning a particular goal or task

wither the team in session or are at different locations.

Participant should support the consensus idea even if they don’t agree.
5) Cause and effect diagram (Ishikawa) (fishbone)

Is a display of the relationship between an effect ( problem ) and all the

possible causes impacting it.

First : identify the problem (effect ) statement at the top of diagram.

y
bh
sub causes> can be identified by using 5WHYS

Causes may be 5M (machine, material, manpower, methods, management)

So
Or 5P (people, provision, polices, procedures, place)

a
m
es
N
r/
D

6) interrelationship diagram

A tool allows a team to analyse all the interrelated cause and effect
relationships and factors involved in a complex problem.

According to number of arrows, there are 3 types of relationship (high

relationship, weak relationship, no relationship)
7) Affinity diagram

Used in the beginning of team work to order the jobs after brainstorming

Used to organize large volume of ideas or issues into a major category

y
Affinity means close relationship or connection or similar structure

bh
We should differentiate between primary issues and major related

So
subgroups in order to group the appropriate relationship and links

8) Lotus diagram

a
m
A tool to expand thinking around a single topic (major) to organize ideas
from brainstorming or to organize discussion during planning (for open
es

ended ideas )
N
r/
D

9) Flow Chart

Displays actual steps to identify hand-offs (appropriate-inappropriate),

inefficiencies,

Ex) Used in FMEA, RCA

10) Value Stream Map

It is a very detailed table (SIPOC) to identify value and non value steps in a
process from start to the end of process

y
bh
It is similar to process map but value stream map is for process
standardization

So
11) process map

A story boards
a
m
A problem-solving approach to structure thinking
es

Concerned summary of the problem and it`s solution

N

Includes background-current conditions- goal

r/
D

12) Force Feild Analysis

Used For Change, if you want to apply change what is the driving
forces(strengths) and restraining forces(weaknesses)
13) Check list\ Task list

A list of things to do or obtain in order to keep the team on schedule, to

help team members remember commitment (memory joggers)

14) Gantt Chart (a project planning tool)

y
bh
Includes a list of tasks (process steps) and estimates of time of people of
resources required to complete the quality efforts

So
a
m
es
N
r/
D

16) Priotrization Matrix

A tool used to select one option from a group of alternatives to promote

decision making and concensus
 y
Notes:

bh
So
Data collection tools

- If tally sheet, check sheet, survey > quantitative

a
m
- If observation, interview, focus group> qualitative
es
- The ADDLE training model (analyse, design, develop, implement,
evaluate)
N
r/
D