'Online' monitoring and retrospective analysis of hospital outcomes based on a scan statistic

Statistical tests based on the scan statistic are introduced for detecting possible increases in the occurrence of hospital events. The tests use a moving window and the theoretical aspects of the tests are investigated using Markov chain theory. The main objective of this study is to provide a stat...

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Bibliographic Details
Published in:Statistics in medicine 2003-09, Vol.22 (18), p.2861-2876
Main Authors: Ismail, Noor Azina, Pettitt, A. N., Webster, R. A.
Format: Article
Language:English
Subjects:
adverse events
Australia - epidemiology
Biological and medical sciences
Cross Infection - epidemiology
health care
Hospital Records - statistics & numerical data
Humans
Markov chain
Markov Chains
Medical sciences
Methicillin Resistance
Outcome Assessment (Health Care) - statistics & numerical data
Poisson Distribution
Population Surveillance - methods
process control
retrospective analysis surveillance
Retrospective Studies
Staphylococcal Infections - epidemiology
Surgical Wound Infection - epidemiology
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Summary:Statistical tests based on the scan statistic are introduced for detecting possible increases in the occurrence of hospital events. The tests use a moving window and the theoretical aspects of the tests are investigated using Markov chain theory. The main objective of this study is to provide a statistical technique to assist hospital staff in deciding whether the variation they observe is greater than usually expected under random variation. In this paper we develop the test for Poisson data and apply the theory to monitor the occurrence of orthopaedic wound infection and Methicillin‐resistant Staphylo‐ coccus aureus colonization. We find that this method is sensitive in detecting the change in the process parameter which may not be detected by standard control chart methods. Both online and retrospective analyses are considered. Copyright © 2003 John Wiley & Sons, Ltd.
ISSN:0277-6715
1097-0258
DOI:10.1002/sim.1532