QuEST Mental Health Data for Improvement Network

Run ChartsAlison PickeringSenior Information Analyst

By the end of this session you will…

• know why we use run charts in improvement work

• be able to construct a run chart• understand how to read the run chart• know when to change the median• know how to find further support

Why Run Charts?

“Data have no meaning apart from their context”

W. Shewhart

Worked example

• NHS Somewhere was having trouble with their DNA rate, so they implemented a text reminder system in July 2011. Did it work?

MonthNumber of

DNAsJan-11 9Jan-12 6Jan-13 4

Monthly data

Month Number of DNAsJan-11 9Feb-11 8Mar-11 9Apr-11 6May-11 7Jun-11 5Jul-11 6Aug-11 8Sep-11 9Oct-11 6Nov-11 7Dec-11 6Jan-12 6Feb-12 7Mar-12 9Apr-12 9May-12 8Jun-12 6Jul-12 7Aug-12 8Sep-12 6Oct-12 8Nov-12 7Dec-12 5Jan-13 4

Create a line chart

Find your median

Month Number of DNAsJan-13 4Jun-11 5Dec-12 5Apr-11 6Jul-11 6Oct-11 6Dec-11 6Jan-12 6Jun-12 6Sep-12 6May-11 7Nov-11 7Feb-12 7Jul-12 7Nov-12 7Feb-11 8Aug-11 8May-12 8Aug-12 8Oct-12 8Jan-11 9Mar-11 9Sep-11 9Mar-12 9Apr-12 9

Add the median to your chart

Add titles and labels

Annotate chart with process changes

Run Chart Rules

There are four simple things to look for on a run chart to highlight whether there are significant changes happening:1. A shift2. A trend3. The number of runs4. An astronomical data point

A shift

A trend

Total number of data points Number up or down in a row to indicate special cause

5 to 8 5 or more9 to 20 6 or more21 to 100 7 or more

The number of runs

The number of runs

Data points

Lower limit

Upper limit

15 4 12

16 5 12

17 5 13

18 6 13

19 6 14

20 6 15

21 7 15

22 7 16

23 8 16

24 8 17

Data points

Lower limit

Upper limit

25 9 17

26 9 18

27 9 19

28 10 19

29 10 20

30 11 20

31 11 21

32 11 22

33 11 22

34 12 23

Data points

Lower limit

Upper limit

35 13 23

36 13 24

37 13 25

38 14 25

39 14 26

40 15 26

41 16 26

42 16 27

43 17 27

44 17 28

The number of runs

Astronomical point

Our example

Another example

Median = 3.9

Changing the median

Changing the median example

Conclusion

Source: xkcd.com

Further learning

• Reading:– QI Hub -

www.qihub.scot.nhs.uk/knowledge-centre/quality-improvement-tools/run-chart.aspx

– IHI - www.ihi.org/knowledge/Pages/Tools/RunChart.aspx

– Paper Adobe Acrobat Document

Further support

Alison PickeringSenior Information Analyst

QuEST Mental Health01312443284

alison.pickering@scotland.gsi.gov.uk