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Physician-level quality measurement: Using control charts with national benchmarks to identify common and special cause variation in patients' systolic blood pressures.


Arnold GK, Lipner RS, Lynn LA, Weng W, Holmboe ES. — American Board of Internal Medicine

Presented: Joint Statistical Meetings Conference, August 2009

Abstract: Control charts that identify common or special cause variation in processes are used for physician-level quality measurement. The American Board of Internal Medicine's Maintenance of Certification program includes an assessment of physicians' efforts to improve the quality of patient care through Web-based tools called Practice Improvement Modules. Using the Hypertension PIM, 283 physicians abstracted data from 7,215 medical records of their hypertensive patients. Systolic blood pressures for patients (n>=20) per physician are plotted with short-run, individual moving-range charts. Special cause variation is identified with standard sensitizing rules; rules using systolic BP benchmarks; systolic specification limits not exceeding 20 mm Hg above goals. The benchmark control chart measures quality and consistency of patient care relative to national standards at the physician level.

For more information about this presentation, please contact Research@abim.org.