Resources

The “White” Book

Our free work-in-progress web book Mastering Statistical Process Control Charts in Healthcare is about the practical application of SPC methodology in healthcare.

The book offers a step-by-step guide to easily and correctly producing SPC charts using the R programming language.

Software

There are several R packages for producing SPC charts. We recommend these two:

• qicharts2 – Quality Improvement Charts for R.
  A well-established package that produces the most common types of SPC charts as well as some charts for specialist purposes.

• pbcharts – Process Behaviour Charts: Yet another R package for statistical process control charts.
  An experimental package introducing the I’ (I prime) chart, which adjusts control limits to varying subgroup sizes making pbcharts useful for a wide range of measurement and count data.

Publications

Below is a selection of publications which we have authored, focusing on both the theory and practical application of SPC in healthcare:

• Mohammed MA
  Statistical Process Control. Elements of Improving Quality and Safety in Healthcare
  Cambridge University Press 2024

• Anhøj J, Wentzel-Larsen T
  Sense and sensibility: on the diagnostic value of control chart rules for detection of shifts in time series data
  BMC Med Res Methodol 2018. doi: 10.1186/s12874-018-0564-0

• Anhøj J, Hellesøe AB
  The problem with red, amber, green: the need to avoid distraction by random variation in organisational performance measures
  BMJ Qual Saf 2017. doi: 10.1136/bmjqs-2015-004951

• Anhøj J
  Diagnostic value of run chart analysis: using likelihood ratios to compare run chart rules on simulated data series
  PLoS One 2015. doi: 10.1371/journal.pone.0121349

• Anhøj J, Olesen AV
  Run charts revisited: a simulation study of run chart rules for detection of non-random variation in health care processes
  PLoS One 2014. doi: 10.1371/journal.pone.0113825

• Mohammed MA, Panesar JS, Laney DB, Wilson R
  Statistical Process Control Charts for Attribute Data Involving Very Large Sample Sizes: A Review of Problems and Solutions
  BMJ Qual Saf 2013. doi: 10.1136/bmjqs-2012-001373

• Mohammed MA, Worthington P
  Why traditional statistical process control charts for attribute data should be viewed alongside an xmr-chart
  BMJ Quality & Safety 2013. doi: 10.1136/bmjqs-2012-001324

• Mohammed MA, Worthington P, Woodall WH
  Plotting Basic Control Charts: Tutorial Notes for Healthcare Practitioners
  BMJ Quality & Safety 2008. doi: 10.1136/qshc.2004.012047

• Mohammed MA, Rathbone A, Myers P, Patel D, Onions H, Stevens A
  An Investigation into General Practitioners Associated with High Patient Mortality Flagged up Through the Shipman Inquiry: Retrospective Analysis of Routine Data
  BMJ 2004. https://doi.org/10.1136/bmj.328.7454.1474

• Mohammed MA
  Using statistical process control to improve the quality of health care
  BMJ Quality & Safety 2004. doi: https://doi.org/10.1136/qshc.2004.011650

• Mohammed MA, Cheng KK, Rouse A, Marshall T
  Bristol, Shipman, and Clinical Governance: Shewhart’s Forgotten Lessons
  Lancet 2001. doi: 10.1016/s0140-6736(00)04019-8

Reference books

These books are widely regarded as seminal and authoritative texts of SPC:

• Douglas C Montgomery
  Introduction to Statistical Quality Control
  ISBN: 978-1-119-39930-8
  Wiley 2020

• Donald J Wheeler
  Understanding Variation
  ISBN: 978-0-945320-80-7
  SPC Press 2000

• Western Electric
  Statistical Quality Control Handbook
  Western Electric Co., Inc. 1956

• Walther A Shewhart
  Economic Control Of Quality Of Manufactured Product
  D Van Nostrand Company, Inc. 1931