Application of variables control charts to risk-adjusted time-ordered healthcare data

In a previous article (M. K. Hart, Qual Manag Health Care. 2003;12(1):5-19), the authors presented risk-adjusted control charts applicable for attributes data. The present article discusses a similar class of control charts applicable for variables data that are often skewed. The key feature of these charts is their application of risk-adjusted data in addition to actual performance data. The resulting charts should decrease the occurrence of both type I and type II errors as compared to the unadjusted control charts. This article presents several control charts that vary in the data transformation and combination approaches. Data depicting hospital length of stay following coronary artery bypass graft procedures were used to illustrate the use of transformed and risk-adjusted control charts.