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Risk-adjusted control charts for health care assessment
Authors:Farrokh Alemi  Walter Rom  Eric Eisenstein
Affiliation:(1) Health Care Administration Program, Cleveland State University, 44115 Cleveland, OH, USA;(2) Production and Operations Management Department, Cleveland State University, 44115 Cleveland, OH, USA;(3) Outcomes Research and Assessment Group, Duke University Medical Center, 27710 Durham, NC, USA
Abstract:The recent Joint Commission on Accreditation of Healthcare Organization (JCAHO) requirement that hospital accreditation be based upon a Total Quality Management (TQM) approach has focused the attention of health care administrations on the use of techniques such as control charts. However, control charts are not typically adjusted for severity of illness. This adjustment is needed because, unlike industrial organizations, hospitals are not able to control all of their inputs and must accept variances in their patients. In this paper, we present a methodology for adjusting a health care organization's control charts to reflect their patient population's severity of illness during different time intervals. We then demonstrate that risk-adjusting expected patient outcomes can change our assessments of the relative quality of care offered by a health care organization in different time periods.
Keywords:Control chart  quality of care  risk adjustment  severity of illness  total quality management
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