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Figures, Tables, and Exhibits |
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xiii | |
Preface |
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xxix | |
Acknowledgments |
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xxxiii | |
The Authors |
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xxxv | |
About the Companion Website |
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xxxvii | |
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Part I Using Data for Improvement |
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1 | (222) |
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Chapter 1 Improvement Methodology |
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3 | (24) |
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Fundamental Questions for Improvement |
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4 | (5) |
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What Are We Trying to Accomplish? |
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5 | (2) |
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How Will We Know that a Change is an Improvement? |
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7 | (1) |
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What Changes Can We Make That Will Result in Improvement? |
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8 | (1) |
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The PDSA Cycle for Improvement |
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9 | (17) |
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Tools and Methods to Support the Model for Improvement |
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13 | (2) |
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Designing PDSA Cycles for Testing Changes |
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15 | (4) |
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Analysis of Data from PDSA Cycles |
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19 | (7) |
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26 | (1) |
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26 | (1) |
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Chapter 2 Using Data for Improvement |
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27 | (50) |
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What Does the Concept of Data Mean? |
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27 | (16) |
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29 | (7) |
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36 | (7) |
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Using A Family of Measures |
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43 | (4) |
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The Importance of Operational Definitions |
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47 | (4) |
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Data for Different Types of Studies |
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51 | (2) |
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53 | (8) |
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55 | (3) |
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58 | (3) |
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61 | (2) |
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What about Case-Mix Adjustment? |
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63 | (2) |
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65 | (3) |
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Analysis and Presentation of Data |
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68 | (7) |
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75 | (1) |
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75 | (2) |
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Chapter 3 Understanding Variation Using Run Charts |
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77 | (46) |
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77 | (1) |
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77 | (3) |
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80 | (1) |
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80 | (17) |
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Examples of Run Charts for Improvement Projects |
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84 | (5) |
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Rules to Aid in Interpreting Run Charts |
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89 | (8) |
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Special Issues in Using Run Charts |
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97 | (23) |
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Stratification with Run Charts |
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113 | (3) |
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Using the Cumulative Sum Statistic with Run Charts |
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116 | (4) |
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120 | (1) |
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121 | (2) |
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Chapter 4 Learning from Variation in Data |
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123 | (36) |
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123 | (6) |
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Introduction to Shewhart Charts |
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129 | (6) |
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Depicting and Interpreting Variation Using Shewhart Charts |
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135 | (5) |
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The Role of Annotation with Shewhart Charts |
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140 | (1) |
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Establishing Limits for Shewhart Charts |
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141 | (4) |
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Revising Limits for Shewhart Charts |
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145 | (2) |
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Stratification with Shewhart Charts |
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147 | (5) |
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Shewhart Charts and Targets, Goals, or Other Specifications |
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152 | (3) |
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Special Cause: Is It Good or Bad? |
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155 | (2) |
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157 | (1) |
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158 | (1) |
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Chapter 5 Understanding Variation Using Shewhart Charts |
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159 | (64) |
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Selecting the Type of Shewhart Chart |
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160 | (3) |
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Shewhart Charts for Continuous Data |
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163 | (1) |
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164 | (7) |
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Examples of Shewhart Charts for Individual Measurements |
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166 | (2) |
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Rational Ordering with an I Chart |
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168 | (2) |
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Example of I Chart for Deviations from a Target |
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170 | (1) |
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171 | (6) |
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Shewhart Charts for Attribute Data |
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177 | (3) |
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Subgroup Size for Attribute Charts |
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178 | (2) |
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The P Chart for Classification Data |
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180 | (8) |
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182 | (4) |
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Creation of Funnel Limits for a P Chart |
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186 | (2) |
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Shewhart Charts for Counts of Nonconformities |
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188 | (2) |
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190 | (2) |
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192 | (5) |
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Creation of Funnel Limits for a U Chart |
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195 | (2) |
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Alternatives for Attribute Charts for Rare Events |
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197 | (9) |
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G Chart for Opportunities Between Rare Events |
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198 | (4) |
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T Chart for Time Between Rare Events |
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202 | (4) |
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206 | (5) |
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Process Capability from an I Chart |
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208 | (1) |
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Capability of a Process from Xbar and S Charts |
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208 | (2) |
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Capability of a Process from Attribute Control Charts |
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210 | (1) |
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Capability from a P Chart |
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210 | (1) |
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Capability from a C or U Chart |
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210 | (1) |
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211 | (1) |
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212 | (1) |
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5.1 Calculating Shewhart Limits |
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213 | (1) |
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I Chart (For Individual Values Of Continuous Data) |
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213 | (1) |
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Xbar S Chart (For Continuous Data In Subgroups) |
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214 | (3) |
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P Chart (For Classification Data) |
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217 | (1) |
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C Chart (Count Of Incidences) |
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218 | (1) |
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U Chart (Incidences Per Area Of Opportunity) |
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219 | (1) |
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G Chart (Cases Between Incidences) |
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220 | (1) |
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221 | (2) |
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Additional Tools For Understanding Variation In Data |
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223 | (74) |
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223 | (2) |
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Additional Tools for Learning from Variation |
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225 | (1) |
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225 | (11) |
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Frequency Plot Construction |
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226 | (2) |
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Frequency Plots Used with Shewhart Charts |
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228 | (4) |
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Frequency Plots and Stratification |
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232 | (4) |
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236 | (14) |
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Pareto Chart Construction |
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238 | (1) |
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Pareto Charts Used with Shewhart Charts |
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239 | (5) |
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Pareto Chart and Stratification |
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244 | (6) |
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250 | (10) |
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251 | (3) |
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Scatterplots Used with Shewhart Charts |
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254 | (4) |
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Scatterplots and Stratification |
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258 | (2) |
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260 | (5) |
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Constructing a Radar Chart |
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261 | (1) |
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Radar Charts Used with Shewhart Charts |
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261 | (2) |
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Radar Charts and Stratification |
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263 | (2) |
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265 | (1) |
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265 | (2) |
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Chapter 7 Shewhart Chart Savvy: Dealing with Common Issues |
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267 | (30) |
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Creating Effective Shewhart Charts |
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267 | (12) |
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Tip 1 Type of Data and Subgroup Size |
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267 | (1) |
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268 | (1) |
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268 | (6) |
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Tip 4 Decisions for Recalculating limits, or Rephasing, on a Shewhart Chart |
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274 | (3) |
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Extending Centerline and Limits Backward |
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277 | (2) |
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Typical Problems with Software for Calculating Shewhart Charts |
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279 | (6) |
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Characteristics to Consider When Purchasing SPC Software |
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282 | (3) |
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Another Caution with I Charts and Chart Selection |
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285 | (2) |
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Guidelines for Shewhart Charts in Research Studies and Publications |
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287 | (5) |
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Use of Shewhart Charts in Research Studies |
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288 | (2) |
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Shewhart Charts in Publications |
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290 | (2) |
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Shewhart's Theory versus Statistical Inference |
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292 | (4) |
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296 | (1) |
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296 | (1) |
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Part II Advanced Theory and Methods with Data For Improvement |
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297 | (106) |
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Chapter 8 More Shewhart-Type Charts |
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299 | (42) |
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Other Shewhart-Type Charts |
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301 | (15) |
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301 | (1) |
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Xbar Range (Xbar R) Chart |
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302 | (2) |
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304 | (2) |
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Attribute Charts with Large Subgroup Sizes (P' and U') |
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306 | (1) |
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307 | (6) |
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313 | (3) |
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Some Adaptations to Shewhart Charts |
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316 | (22) |
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317 | (3) |
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320 | (8) |
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Exponentially Weighted Moving Average (EWMA) Chart |
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328 | (3) |
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Standardized Shewhart Charts |
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331 | (3) |
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Multivariate Shewhart-Type Charts |
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334 | (4) |
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338 | (1) |
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339 | (2) |
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Chapter 9 Special Uses for Shewhart Charts |
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341 | (34) |
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Shewhart Charts with a Changing Centerline |
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341 | (20) |
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Shewhart Charts with a Sloping Centerline |
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342 | (2) |
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Shewhart Charts with Seasonal Effects |
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344 | (5) |
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Adjusting Shewhart Charts for Confounders |
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349 | (6) |
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Transformation of Data with Shewhart Charts |
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355 | (6) |
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Shewhart Charts for Autocorrelated Data |
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361 | (12) |
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Risk-Adjusted or Case-Mix Adjusted Shewhart Charts |
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366 | (2) |
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368 | (1) |
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Confidence Intervals and Confidence Limits |
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369 | (4) |
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373 | (1) |
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373 | (2) |
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Chapter 10 Drilling Down into Aggregate Data for Improvement II |
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375 | (28) |
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375 | (1) |
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What is the Challenge Presented by Aggregate Data? |
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376 | (5) |
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Introduction to the Drill Down Pathway |
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381 | (3) |
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381 | (1) |
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382 | (1) |
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383 | (1) |
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An Illustration of the Drill Down Pathway: Adverse Drug Events |
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384 | (19) |
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Drill Down Pathway Step One |
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385 | (1) |
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Drill Down Pathway Step Two |
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385 | (2) |
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Drill Down Pathway Step Three |
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387 | (2) |
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Drill Down Pathway Step Three, Continued |
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389 | (4) |
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Drill Down Pathway Step Four |
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393 | (4) |
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Drill Down Pathway Step Five |
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397 | (3) |
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Drill Down Pathway Step Six |
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400 | (1) |
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400 | (1) |
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401 | (2) |
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Part III Applications of Shewhart Charts in Health Care |
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403 | (192) |
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Chapter 11 Learning from Individual Patient Data |
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405 | (20) |
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Examples of Shewhart Charts for Individual Patients |
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407 | (18) |
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Example 1 Asthma Patient Use of Shewhart Charts |
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408 | (1) |
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Example 2 Prostate-Specific Antigen (PSA) Screening for Prostate Cancer |
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409 | (2) |
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Example 3 Monitoring Patient Measures in the Hospital |
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411 | (1) |
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Example 4 Bone Density for a Patient Diagnosed with Osteoporosis |
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412 | (3) |
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Example 5 Temperature Readings for a Hospitalized Patient |
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415 | (3) |
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Example 6 Shewhart Charts for Continuous Monitoring of Patients |
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418 | (2) |
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Example 7 Monitoring Weight |
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420 | (1) |
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Example 8 Monitoring Blood Sugar Control for Patients with Diabetes |
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421 | (1) |
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Example 9 Using Shewhart Charts in Pain Management |
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422 | (1) |
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423 | (2) |
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Chapter 12 Learning from Patient Feedback to Improve Care |
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425 | (26) |
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Summarizing Patient Feedback Data |
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429 | (8) |
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Presentation of Patient Satisfaction Data |
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437 | (1) |
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Using Patient Feedback for Improvement |
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438 | (7) |
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The PDSA Cycle for Testing and Implementing Changes |
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438 | (1) |
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Improvement Team Working on Clinic Satisfaction |
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438 | (4) |
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Improvement Team Working on Pain |
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442 | (2) |
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444 | (1) |
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Using Patient Satisfaction Data in Planning for Improvement |
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445 | (2) |
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Special Issues with Patient Feedback Data |
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447 | (4) |
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Are There Challenges When Summarizing and Using Patient Satisfaction Survey Data? |
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447 | (2) |
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Does Survey Scale Matter? |
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449 | (1) |
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450 | (1) |
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450 | (1) |
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Chapter 13 Using Shewhart Charts in Health Care Leadership |
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451 | (24) |
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A Health Care Organization's Vector of Measures |
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452 | (1) |
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453 | (8) |
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So How do We Best Display a VOM? |
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461 | (3) |
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Administrative Issues with a VOM |
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464 | (3) |
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Some Examples of Measures for Other VOMs |
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467 | (8) |
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468 | (1) |
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468 | (1) |
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469 | (1) |
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469 | (2) |
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471 | (1) |
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IHI Whole System Measures |
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471 | (2) |
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473 | (1) |
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474 | (1) |
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Chapter 14 Shewhart Charts for Epidemic Data |
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475 | (18) |
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Shewhart Charts in Epidemiology |
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476 | (3) |
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Development of Shewhart Charts for Epidemic Data |
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479 | (8) |
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479 | (2) |
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481 | (4) |
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485 | (1) |
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486 | (1) |
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Some Issues with the Hybrid Chart for COVID-19 Deaths |
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487 | (6) |
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487 | (1) |
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Day-of-the-Week Adjustment |
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487 | (2) |
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Application of the Hybrid Charts to Cases, Hospitalizations, and Intensive Care Unit Admissions |
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489 | (3) |
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492 | (1) |
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492 | (1) |
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493 | (102) |
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Case Study A Improving Access to a Specialty Care Clinic |
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495 | (9) |
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Case Study B Radiology Improvement Projects |
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504 | (10) |
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Case Study C Reducing Post-Cabg Infections |
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514 | (12) |
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Case Study D Drilling Down into Percentage of C-Sections |
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526 | (11) |
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Case Study E Reducing Length of Stay After Surgery |
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537 | (14) |
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Case Study F Reducing Hospital admissions |
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551 | (7) |
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Case Study G Accidental Puncture/Laceradon Rate |
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558 | (10) |
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Case Study H Improving Telemedicine Failed Calls and No Shows |
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568 | (15) |
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Case Study I Variation in Financial Data |
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583 | (12) |
Index |
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595 | (14) |
Shewhart Chart Selection Guide |
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609 | |