THEORY OF STATISTICAL PROCESS CONTROL
The basic theory of statistical process control was developed
in the late 1920s by Dr Walter Shewhart,3 a statistician at the
AT&T Bell Laboratories in the USA, and was popularised
worldwide by Dr W Edwards Deming.4 Both observed that
repeated measurements from a process will exhibit variation—
Shewhart originally worked with manufacturing processes
but he and Deming quickly realized that their
observation could be applied to any sort of process. If a
process is stable, its variation will be predictable and can be
described by one of several statistical distributions.
One such model of random variation is the normal (or
Gaussian) bell shaped distribution which is familiar to most
healthcare professionals. While repeated measurements from
many processes follow normal distributions, it is important to
note that there are many other types of distributions that
describe the variation in other healthcare measurements such
as Poisson, binomial, or geometric distributions. For example,
the random variation in the number of wound infections
after surgery will follow a binomial distribution since there
are only two possible outcomes—each patient either did or
did not have a postoperative infection with about the same
probability (assuming that the data are adjusted for patient
acuity, surgical techniques, and other such variables).
SPC theory uses the phrase ‘‘common cause variation’’to
refer to the natural variation inherent in a process on a
regular basis. This is the variation that is expected to occur
according to the underlying statistical distribution if its
parameters remain constant over time. For example, the
random variation between body temperatures within a
population of healthy people is a result of basic human
physiology, while the random variation in week to week
wound infection rates is a result of factors such as training,
sources of supplies, surgical and nursing care practices, and
cleanliness procedures. Processes that exhibit only common
cause variation are said to be stable, predictable, and in
‘‘statistical control’’, hence the major tool of SPC is called the
‘‘statistical control chart’’.
THEORY OF STATISTICAL PROCESS CONTROL
The basic theory of statistical process control was developed
in the late 1920s by Dr Walter Shewhart,3 a statistician at the
AT&T Bell Laboratories in the USA, and was popularised
worldwide by Dr W Edwards Deming.4 Both observed that
repeated measurements from a process will exhibit variation—
Shewhart originally worked with manufacturing processes
but he and Deming quickly realized that their
observation could be applied to any sort of process. If a
process is stable, its variation will be predictable and can be
described by one of several statistical distributions.
One such model of random variation is the normal (or
Gaussian) bell shaped distribution which is familiar to most
healthcare professionals. While repeated measurements from
many processes follow normal distributions, it is important to
note that there are many other types of distributions that
describe the variation in other healthcare measurements such
as Poisson, binomial, or geometric distributions. For example,
the random variation in the number of wound infections
after surgery will follow a binomial distribution since there
are only two possible outcomes—each patient either did or
did not have a postoperative infection with about the same
probability (assuming that the data are adjusted for patient
acuity, surgical techniques, and other such variables).
SPC theory uses the phrase ‘‘common cause variation’’to
refer to the natural variation inherent in a process on a
regular basis. This is the variation that is expected to occur
according to the underlying statistical distribution if its
parameters remain constant over time. For example, the
random variation between body temperatures within a
population of healthy people is a result of basic human
physiology, while the random variation in week to week
wound infection rates is a result of factors such as training,
sources of supplies, surgical and nursing care practices, and
cleanliness procedures. Processes that exhibit only common
cause variation are said to be stable, predictable, and in
‘‘statistical control’’, hence the major tool of SPC is called the
‘‘statistical control chart’’.
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