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THE HEALTH CARE
DATA GUIDE
Learning from Data for
Improvement

Second Edition

LLOYD P. PROVOST
SANDRA K. MURRAY
WEBSITE FOR INSTRUCTORS:

www.wiley.com\go\provost\healthcaredata2e
This edition first published 2022
© 2022 John Wiley & Sons, Inc.
Edition History
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Library of Congress Cataloging-in-Publication Data
Names: Provost, Lloyd P., author. | Murray, Sandra K., author.
Title: The health care data guide : learning from data for improvement /
Lloyd P. Provost, Sandra K. Murray.
Description: Second edition. | Hoboken, NJ : John Wiley & Sons, 2022. |
Includes bibliographical references and index.
Identifiers: LCCN 2021053032 (print) | LCCN 2021053033 (ebook) | ISBN
9781119690139 (paperback) | ISBN 9781119690153 (pdf) | ISBN
9781119690122 (epub)
Subjects: LCSH: Medical care--Quality control--Statistical methods. |
Medical care--Quality control--Data processing.
Classification: LCC RA399.A3 P766 2022 (print) | LCC RA399.A3 (ebook) |
DDC 362.10727--dc23/eng/20211123
LC record available at https://lccn.loc.gov/2021053032
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10 9 8 7 6 5 4 3 2 1
 C O N T E N T S

Figures, Tables, and Exhibits xiii

Preface xxix
The Authors xxxv
About the Companion Website xxxvii

Part I Using Data for Improvement 1

Chapter 1 Improvement Methodology 3

Fundamental Questions for Improvement 4
What Are We Trying to Accomplish? 5
How Will We Know that a Change is an Improvement? 7
What Changes Can We Make That Will Result in Improvement? 8
The PDSA Cycle for Improvement 9
Tools and Methods to Support the Model for Improvement 13
Designing PDSA Cycles for Testing Changes 15
Analysis of Data from PDSA Cycles 19
Summary26
Key Terms 26

Chapter 2 Using Data for Improvement 27

What Does the Concept of Data Mean? 27
How are Data Used? 29
Types of Data 36
Using A Family of Measures 43
The Importance of Operational Definitions 47
Sampling53
Sampling Strategies 55
What About Sample Size? 58
Stratification of Data 61
What about Case-Mix Adjustment? 63
Transforming Data 65
Analysis and Presentation of Data 68
Summary75
Key Terms 75
 vi CONTENTS

Chapter 3 Understanding Variation Using Run Charts 77

Introduction77
What Is a Run Chart? 77
Use of a Run Chart 80
Constructing a Run Chart 80
Examples of Run Charts for Improvement Projects 84
Rules to Aid in Interpreting Run Charts 89
Special Issues in Using Run Charts 97
Stratification with Run Charts 113
Using the Cumulative Sum Statistic with Run Charts 116
Summary120
Key Terms 121

Chapter 4 Learning from Variation in Data 123

The Concept of Variation 123
Introduction to Shewhart Charts 129
Depicting and Interpreting Variation Using Shewhart Charts 135
The Role of Annotation with Shewhart Charts 140
Establishing Limits for Shewhart Charts 141
Revising Limits for Shewhart Charts 145
Stratification with Shewhart Charts 147
Shewhart Charts and Targets, Goals, or Other Specifications 152
Special Cause: Is It Good or Bad? 155
Summary157
Key Terms 158

Chapter 5 Understanding Variation Using Shewhart Charts 159

Selecting the Type of Shewhart Chart 160
Shewhart Charts for Continuous Data 163
I Charts 164
Examples of Shewhart Charts for Individual Measurements 166
Rational Ordering with an I Chart 168
Example of I Chart for Deviations from a Target 170
Xbar S Shewhart Charts 171
Shewhart Charts for Attribute Data 177
Subgroup Size for Attribute Charts 178
The P Chart for Classification Data 180
Examples of P Charts 182
Creation of Funnel Limits for a P Chart 186
Shewhart Charts for Counts of Nonconformities 188
C Charts 190
U Chart 192
Creation of Funnel Limits for a U Chart 195
 CONTENTS vii

Alternatives for Attribute Charts for Rare Events 197

G Chart for Opportunities Between Rare Events 198
T Chart for Time Between Rare Events 202
Process Capability 206
Process Capability from an I Chart 208
Capability of a Process from Xbar and S Charts 208
Capability of a Process from Attribute Control Charts 210
Capability from a P Chart 210
Capability from a C or U Chart 210
Summary211
Key Terms 212

Appendix 5.1 Calculating Shewhart Limits 213

I Chart (For Individual Values Of Continuous Data) 213
Xbar S Chart (For Continuous Data In Subgroups) 214
P Chart (For Classification Data) 217
C Chart (Count Of Incidences) 218
U Chart (Incidences Per Area Of Opportunity) 219
G Chart (Cases Between Incidences) 220
T Chart 221

Chapter 6 Additional Tools For Understanding Variation In Data 223

Depicting Variation 223
Additional Tools for Learning from Variation 225
Frequency Plots 225
Frequency Plot Construction 226
Frequency Plots Used with Shewhart Charts 228
Frequency Plots and Stratification 232
Pareto Charts 236
Pareto Chart Construction 238
Pareto Charts Used with Shewhart Charts 239
Pareto Chart and Stratification 244
Scatterplots250
Scatterplot Construction 251
Scatterplots Used with Shewhart Charts 254
Scatterplots and Stratification 258
Radar Charts 260
Constructing a Radar Chart 261
Radar Charts Used with Shewhart Charts 261
Radar Charts and Stratification 263
Summary265
Key Terms 265
viii CONTENTS

Chapter 7 Shewhart Chart Savvy: Dealing with Common Issues 267

Creating Effective Shewhart Charts 267
Tip 1: Type of Data and Subgroup Size 267
Tip 2: Rounding Data 268
Tip 3: Formatting Charts 268
Tip 4. Decisions for Recalculating limits, or Rephasing, on a
Shewhart Chart 274
Extending Centerline and Limits Backward 277
Typical Problems with Software for Calculating Shewhart Charts 279
Characteristics to Consider When Purchasing SPC Software 282
Another Caution with I Charts and Chart Selection 285
Guidelines for Shewhart Charts in Research Studies
and Publications 287
Use of Shewhart Charts in Research Studies 288
Shewhart Charts in Publications 290
Shewhart’s Theory versus Statistical Inference 292
Summary296
Key Terms 296

Part II Advanced Theory and Methods with Data

For Improvement 297

Chapter 8 More Shewhart-Type Charts 299

Other Shewhart-Type Charts 301
The NP Chart 301
Xbar Range (Xbar R) Chart 302
Median Chart 304
Attribute Charts with Large Subgroup Sizes (P’ and U’) 306
Prime Charts (P’ and U’) 307
Negative Binomial Chart 313
Some Adaptations to Shewhart Charts 316
MA Chart 317
CUSUM Chart 320
Exponentially Weighted Moving Average (EWMA) Chart 328
Standardized Shewhart Charts 331
Multivariate Shewhart-Type Charts 334
Summary338
Key Terms 339

Chapter 9 Special Uses for Shewhart Charts 341

Shewhart Charts with a Changing Centerline 341
Shewhart Charts with a Sloping Centerline 342
Shewhart Charts with Seasonal Effects 343
Adjusting Shewhart Charts for Confounders 349
Transformation of Data with Shewhart Charts 355
 CONTENTS ix

Shewhart Charts for Autocorrelated Data 361

Risk-Adjusted or Case-Mix Adjusted Shewhart Charts 366
Comparison Charts 368
Confidence Intervals and Confidence Limits 369
Summary373
Key Terms 373

Chapter 10 Drilling Down into Aggregate Data for Improvement II 375
What are Aggregate Data? 375
What is the Challenge Presented by Aggregate Data? 376
Introduction to the Drill Down Pathway 381
Stratification381
Sequencing382
Rational Subgrouping 383
An Illustration of the Drill Down Pathway: Adverse Drug
Events384
Drill Down Pathway Step One 385
Drill Down Pathway Step Two 385
Drill Down Pathway Step Three 387
Drill Down Pathway Step Three, Continued 389
Drill Down Pathway Step Four 393
Drill Down Pathway Step Five 397
Drill Down Pathway Step Six 400
Summary400
Key Terms 401

Part III Applications of Shewhart Charts in Health Care 403

Chapter 11 Learning from Individual Patient Data 405

Examples of Shewhart Charts for Individual Patients 407
Example 1: Asthma Patient Use of Shewhart Charts 408
Example 2: Prostate-Specific Antigen (PSA) Screening for
Prostate Cancer 409
Example 3: Monitoring Patient Measures in the Hospital 411
Example 4: Bone Density for a Patient Diagnosed
with Osteoporosis 412
Example 5: Temperature Readings for a Hospitalized Patient 415
Example 6: Shewhart Charts for Continuous Monitoring
of Patients 418
Example 7: Monitoring Weight 420
Example 8: Monitoring Blood Sugar Control for
Patients with Diabetes 421
Example 9: Using Shewhart Charts in Pain Management 422
Summary423
 x CONTENTS

Chapter 12 Learning from Patient Feedback to Improve Care 425

Summarizing Patient Feedback Data 429
Presentation of Patient Satisfaction Data 437
Using Patient Feedback for Improvement 438
The PDSA Cycle for Testing and Implementing Changes 438
Improvement Team Working on Clinic Satisfaction 438
Improvement Team Working on Pain 442
Feedback from Employees 444
Using Patient Satisfaction Data in Planning for Improvement 445
Special Issues with Patient Feedback Data 447
Are There Challenges When Summarizing and Using Patient
Satisfaction Survey Data? 447
Does Survey Scale Matter? 449
Summary450
Key Terms 450

Chapter 13 Using Shewhart Charts in Health Care Leadership 451

A Health Care Organization’s Vector of Measures 452
Developing a VOM 453
So How do We Best Display a VOM? 461
Administrative Issues with a VOM 464
Some Examples of Measures for Other VOMs 467
Emergency Department 468
Primary Care Center 468
System Flow Measures 469
Health Authority 469
Large Urban Hospital 471
IHI Whole System Measures 471
Summary473
Key Terms 474

Chapter 14 Shewhart Charts for Epidemic Data 475

Shewhart Charts in Epidemiology 476
Development of Shewhart Charts for Epidemic Data 479
C Charts (Epoch 1) 479
Charts of Epoch 2 481
Charts for Epoch 3 485
Charts for Epoch 4 486
Some Issues with the Hybrid Chart for COVID-19 Deaths 487
Data Quality 487
Day-of-the-Week Adjustment 487
Application of the Hybrid Charts to Cases, Hospitalizations,
and Intensive Care Unit Admissions 489
Summary492
Key Term 492
 CONTENTS xi

Chapter 15 Case Studies 493

Case Study A: Improving Access to a Specialty Care Clinic 495
Case Study B: Radiology Improvement Projects 504
Case Study C: Reducing Post-Cabg Infections 514
Case Study D: Drilling Down into Percentage of C-Sections 526
Case Study E: Reducing Length of Stay After Surgery 537
Case Study F: Reducing Hospital admissions 551
Case Study G: Accidental Puncture/Laceration Rate 558
Case Study H: Improving Telemedicine Failed Calls
and No Shows 568
Case Study I: Variation in Financial Data 583

Index595

Shewhart Chart Selection Guide 609

 F I G U R E S, TA B L E S, A N D E X H I B I TS

FIGURES

FIGURE 1.1 Model for Improvement 4

FIGURE 1.2 The PDSA cycle 9
FIGURE 1.3 Sequential PDSA Cycles for Learning and Improvement 10
FIGURE 1.4 PDSA Cycles from Testing to Implementation 12
FIGURE 1.5 Results of a Before-and-After Test: Case 1 16
FIGURE 1.6 Other Possible Run Charts Associated with
Before-and-After Graph 17
FIGURE 1.7 Analysis of Data from a PDSA Cycle 21
FIGURE 1.8 Run Charts of Key Measures for Diabetes
Improvement Project 25
FIGURE 2.1 Sources of Data 28
FIGURE 2.2 Measurement for Judgment versus Improvement 32
FIGURE 2.3 Moving from Judgment to Improvement Measures 33
FIGURE 2.4 Using Percentile Rankings 33
FIGURE 2.5 Measure Based on an Index Instead of Actual Units 34
FIGURE 2.6 Simple Scales for Turning Personal Experience into Data 37
FIGURE 2.7 Percentage of DRG Exceeding LOS Guidelines Indicating
Improvement43
FIGURE 2.8 Percentage of Unplanned Readmissions Worsening 44
FIGURE 2.9 Multiple Measures on a Single Graph 44
FIGURE 2.10 Surgical Safety FOM 46
FIGURE 2.11 Image Reflective of an Enumerative Study 51
FIGURE 2.12 Image Reflective of an Analytic Study 52
FIGURE 2.13 Large Sample Compared to Small Sample 54
FIGURE 2.14 Sample Size and Ability to Detect Change 59
FIGURE 2.15 Stratification Involves Separation and Classification 61
FIGURE 2.16 Shewhart Chart of Post-CABG Complication Rate
Without Stratification 62
FIGURE 2.17 Post-CABG Complication Rate Stratified by Protocol 62
FIGURE 2.18 Little Difference Between Risk-Adjusted
and Non-Risk-Adjusted Data 63
FIGURE 2.19 Large Differences Between Risk-Adjusted
and Non-Risk-Adjusted Data 64
FIGURE 2.20 Run Chart of Number of Falls 65
FIGURE 2.21 Run Chart of Rate of Falls 66
FIGURE 2.22 Graphs of Fall Rate and Number of Falls 66
FIGURE 2.23 Patient Waiting Time 68
xiv FIGURES, TABLES, AND EXHIBITS

FIGURE 2.24 Tools to Learn from Variation in Data 72

FIGURE 2.25 Scatter Plots for Data in Table 2.18 74
FIGURE 3.1 Historical Example of a Run Chart 78
FIGURE 3.2 Run Chart Example 78
FIGURE 3.3 Run Chart Leading to Questions 79
FIGURE 3.4 Run Chart with Labels and Median 82
FIGURE 3.5 Run Chart with Goal Line and Tests of Change Annotated 83
FIGURE 3.6 Stat Lab Run Chart with No Evidence of Improvement 84
FIGURE 3.7 Improvement Evident Using a Set of Run Charts Viewed on
One Page 85
FIGURE 3.8 Run Charts Used as Small Multiples 86
FIGURE 3.9 Run Chart Displaying Multiple Measures 87
FIGURE 3.10 Run Chart Displaying a Different Measure for Each Axis 87
FIGURE 3.11 Run Chart Displaying Multiple Statistics for the
Same Measure 88
FIGURE 3.12 Run Chart with Little Data 88
FIGURE 3.13 Run Chart with Clinic Team Uncertain About Improvement 89
FIGURE 3.14 Four Rules for Identifying Nonrandom Signals of Change 90
FIGURE 3.15 Run Chart Evaluating Number of Runs 92
FIGURE 3.16 Measure with Too Few Runs 93
FIGURE 3.17 Run Chart with Too Many Runs 94
FIGURE 3.18 Run Charts of Clinic Cycle Time 95
FIGURE 3.19 Average Time to Administer Antibiotics 96
FIGURE 3.20 Three Key Uses of Run Charts in Improvement Initiatives 98
FIGURE 3.21 Beginning a Run Chart as Soon as the First Data
Are Available 100
FIGURE 3.22 Run Charts for Waiting Time Data 101
FIGURE 3.23 Delay Detecting Signal with Proper Median Technique 102
FIGURE 3.24 Detecting Signal with Proper Median Technique 102
FIGURE 3.25 Detecting Signal of Improvement with Two Medians 103
FIGURE 3.26 Two Cases When Median Ineffective on Run Chart 104
FIGURE 3.27 Run Chart of Incidents Resulting in Too Many Zeros 105
FIGURE 3.28 Run Chart of Cases between an Incident 105
FIGURE 3.29 Starting and Updating Chart of Cases between
Undesirable Rare Events 106
FIGURE 3.30 Mature Run Charts Tracking Cases Between Rare Events 107
FIGURE 3.31 Use of Data Line on Run Chart 108
FIGURE 3.32 Data from Unequal Time Intervals Displayed in Usual
Run Chart 108
FIGURE 3.33 Data From Unequal Time Intervals Displayed to Reveal
Impact of Time 109
FIGURE 3.34 Run Chart from Figure 3.22 With Seventh Week Added 110
FIGURE 3.35 Run Chart with Inappropriate Use of Trend Line 110
FIGURE 3.36 Run Chart of Autocorrelated Data from a Patient Registry 111
FIGURE 3.37 Run Chart with Percentage Doubled in Most Recent Month 112
FIGURE 3.38 Shewhart Control Chart (P Chart) Adjusting Limits Based
on Denominator Size 113
 FIGURES, TABLES, AND EXHIBITS xv

FIGURE 3.39 Infant Mortality Data Stratified Using a Run Chart 114
FIGURE 3.40 Harm Data Stratified Using a Run Chart 115
FIGURE 3.41 Multi-Vari Chart 117
FIGURE 3.42 Run Chart and CUSUM Run Chart of Patient
Satisfaction Data 119
FIGURE 4.1 Using Shewhart Charts to Give Direction to an
Improvement Effort 128
FIGURE 4.2 Example of Shewhart Chart with Equal Subgroup Size 131
FIGURE 4.3 Example of Shewhart Chart with Unequal Subgroup Size 131
FIGURE 4.4 Rules for Detecting a Special Cause 135
FIGURE 4.5 Detecting “Losing the Gains” For an Improved Process 137
FIGURE 4.6 Depicting Variation Using a Run Chart versus a
Shewhart Chart 137
FIGURE 4.7 Shewhart Charts Common Cause and Special
Cause Systems 138
FIGURE 4.8 Shewhart Chart Revealing Process or System
Improvement138
FIGURE 4.9 Shewhart Chart Using Rational Subgrouping 139
FIGURE 4.10 Shewhart Chart Using Stratification 139
FIGURE 4.11 Shewhart Charts Depicting a Process or System “Holding
the Gain” 140
FIGURE 4.12 Run Charts and Shewhart Charts for Waiting Time Data 142
FIGURE 4.13 Improper and Proper Extension of Baseline Limits
on Shewhart Chart 143
FIGURE 4.14 Dealing with Special Cause Data in Baseline Limits 144
FIGURE 4.15 Recalculating Limits After Special Cause Improvement 146
FIGURE 4.16 Recalculating Limits after Exhausting Efforts to
Remove Special Cause 146
FIGURE 4.17 Stratification of Laboratory Data with a Shewhart Chart 148
FIGURE 4.18 Disaggregation of ADEs Data 149
FIGURE 4.19 ADE Rate Rationally Subgrouped in
Different Ways 151
FIGURE 4.20 Shewhart Chart Meeting Goal but Unstable 153
FIGURE 4.21 Shewhart Chart Stable but Not Meeting Goal 154
FIGURE 4.22 Special Cause in Desirable Direction 155
FIGURE 4.23 Shewhart Chart with Special Cause in Undesirable
Direction156
FIGURE 4.24 Shewhart Chart for LOS 157
FIGURE 4.25 Percentage of Patients with an Unplanned Readmission 157
FIGURE 5.1 Shewhart Chart Selection Guide 161
FIGURE 5.2 I Chart for Volume of Infectious Waste 167
FIGURE 5.3 I Chart Extended and Updated with New Limits 167
FIGURE 5.4 Rational Ordering for an I Chart for Intake Process 168
FIGURE 5.5 I Chart for Budget Variances 170
FIGURE 5.6 Xbar S Chart for Radiology Test Turnaround Time 172
FIGURE 5.7 Xbar S Chart for LOS 173
FIGURE 5.8 Xbar S Chart for LOS by Provider 174
xvi FIGURES, TABLES, AND EXHIBITS

FIGURE 5.9 Xbar and S Chart Subgrouped by Provider and Quarter 175
FIGURE 5.10 Xbar S Chart Showing Improvement in Deviation from
Start Times 176
FIGURE 5.11 P Chart for Percentage of Patients Harmed 182
FIGURE 5.12 Extended P Chart for Percentage of Patients Harmed 183
FIGURE 5.13 P Chart Showing Second Phase After Improvement 184
FIGURE 5.14 P Chart for Percentage of Unplanned Readmissions 185
FIGURE 5.15 P Chart for Percentage of MRSA for Hospital System 186
FIGURE 5.16 Funnel Plot of P Chart for Percentage of MRSA for
Hospital System 187
FIGURE 5.17 P Chart with Funnel Limits for Systemwide Medication
Compliance188
FIGURE 5.18 C Chart for Employee Needlesticks 191
FIGURE 5.19 C Chart for Issues by Surgeon 192
FIGURE 5.20 U Chart for Flash Sterilization 193
FIGURE 5.21 U Charts Showing the Effect of Choosing the Standard
Area of Opportunity 195
FIGURE 5.22 U Chart for Complaints by Clinic with Funnel Limits 196
FIGURE 5.23 Comparison of G Chart to U Chart 199
FIGURE 5.24 G Chart for ADEs 201
FIGURE 5.25 T Chart for Number of Days between ADEs 202
FIGURE 5.26 Different Formats for Displaying a T Chart 204
FIGURE 5.27 T Chart for Retained Foreign Objects 205
FIGURE 5.28 Process Capability: Typical Situations and Actions 207
FIGURE 5.29 Capability From an I Chart 208
FIGURE 5.30 Capability Analysis from an Xbar S Chart 209
FIGURE 6.1 Tools to Learn from Variation in Data 224
FIGURE 6.2 Histogram, Dot Plot, and Stem-and-Leaf Plot for Age at Fall 225
FIGURE 6.3 Frequency Plot (Dot Plot) of Patient Satisfaction Data 226
FIGURE 6.4 Age of Children with Head Injury 228
FIGURE 6.5 Shewhart Chart of Average Minutes to Initiate
Antibiotics for Sepsis Patients 229
FIGURE 6.6 Histogram of Minutes to Antibiotic Start for Patients with
Sepsis230
FIGURE 6.7 Stable Shewhart Chart of Patient Fall Rate 230
FIGURE 6.8 Histogram of Age of People Who Fell 231
FIGURE 6.9 Distribution of Data without and with Skew 231
FIGURE 6.10 Frequency Plot of Clinic Patient Wait Time 232
FIGURE 6.11 Stratified Histograms of Patient Falls by Time of Day 233
FIGURE 6.12 Histogram of Antibiotic Start Time Stratified by Location 234
FIGURE 6.13 Shewhart Chart of Average Patient Satisfaction 235
FIGURE 6.14 Histograms Stratified by Common Cause and Special Cause
Timeframes236
FIGURE 6.15 Example of a Pareto Chart 237
FIGURE 6.16 Pareto Chart with Cumulative Percentage Line 239
FIGURE 6.17 Stable Shewhart Chart of SMC Readmission 240
FIGURE 6.18 Pareto Chart of Cited Reasons for SMC Adult Readmission 240
 FIGURES, TABLES, AND EXHIBITS xvii

FIGURE 6.19 Factors Noted with Late Antibiotic Administration

on Nursing Units 241
FIGURE 6.20 Shewhart Chart of Hospital Mortality Percentage 242
FIGURE 6.21 Pareto of Opportunities to Improve 242
FIGURE 6.22 Unweighted Pareto Chart of Nosocomial Infections 243
FIGURE 6.23 Weighted Pareto Chart of Nosocomial Infections 244
FIGURE 6.24 Stratified Pareto Charts of Health Status Stratified by Race 245
FIGURE 6.25 Stratified Pareto Charts of Factors Associated
with Pediatric Head Injuries 246
FIGURE 6.26 Stratified Pareto Charts of Factors Associated
with Patient Falls 247
FIGURE 6.27 Shewhart Chart of Adverse Drug Event Rate 248
FIGURE 6.28 Stratified Pareto Charts of Medications Associated
with ADEs 248
FIGURE 6.29 Stratified Pareto Charts Contrasting Common Cause to
Special Cause Timeframe 249
FIGURE 6.30 Scatterplot of Time with Provider Related to Patient
Satisfaction250
FIGURE 6.31 Scatterplot of Wait Related to Patient Satisfaction 252
FIGURE 6.32 Scatterplot with Trend Line and Statistics Added 253
FIGURE 6.33 Interpreting Patterns on the Scatterplot 254
FIGURE 6.34 Shewhart Chart of Patient Willingness to Recommend the
Clinic255
FIGURE 6.35 Scatterplots Related to Willingness to Recommend
the Clinic 255
FIGURE 6.36 Scatterplot Relating Arrival Time and Time to Start
Antibiotic256
FIGURE 6.37 Scatterplot Relating Days between Case Worker Visits
and QL Scores 257
FIGURE 6.38 Stratified Scatterplots Case Load and Sick Leave Use 258
FIGURE 6.39 Stratified Scatterplots Relating Case Worker Visits
and QL Scores 259
FIGURE 6.40 Stratified Scatterplots Relating Wait Time to Satisfaction 260
FIGURE 6.41 Radar Chart of Satisfaction with Health Care 261
FIGURE 6.42 Patient Satisfaction with Urgent Care 262
FIGURE 6.43 Radar Chart of Satisfaction with Urgent Care by Element 262
FIGURE 6.44 Patient Satisfaction with Urgent Care Showing Special
Cause263
FIGURE 6.45 Radar Charts of Satisfaction with Health Care Stratified
by Common and Special Cause Timeframes 264
FIGURE 6.46 Radar Charts of Patient Satisfaction Stratified by Race 264
FIGURE 7.1 Showing Data Points: (a) With Dots, (b) No Dots 269
FIGURE 7.2 Vertical Scale: (a) Just Right, (b) Too Wide, (c) To
Narrow270
FIGURE 7.3 (a) Inappropriate Vertical Scale, (b) Appropriate Scale 271
FIGURE 7.4 Including 0% and 100% on Vertical Scale 272
FIGURE 7.5 Overuse of Gridlines and Illegible Data Display 273