Georgetown University
Statistical Process Improvement


Link to Others

At the end of each lecture of the course, there are topic-specific links to others  See the sections titled "More" within each lecture..  Here we present a list of general sites of interest. 

  1. Madison Area Quality Improvement Network
  2. Formulary
  3. Quality in Europe
  4. Pubmed Medline With Clinical Search Filters
  5. British Medical Journal Abstracts
  6. Curious Cat online quality resources guide
  7. The Deming quality resources
  8. The American Productivity and Quality Center
  9. QualiNet
  10. Association for Quality and Participation
  11. The Quality Assurance Institute
  12. The USDA's TQM Website
  13. Quality Online Forum's Website
  14. The International Quality & Productivity Center
  15. International Organization for Standardization
  16. American National Standards Institute
  17. The Philip Crosby Website
  18. Quality Digest Magazine's Website
  19. The Quality Management Principles Website
  20. The American Productivity and Quality Center
  21. Glossary of Terms
  22. 10th European Forum on Quality Improvement in Health Care

Links Organized by Lecture Topics

 UNIT 1:

  1. Argyris,C. Knowledge for Action: A Guide to Overcoming Barriers to Organizational Change.  San Francisco: Jossey-Bass, Inc. Publishers, 1993. -- Argyris describes in detail his consultation with a firm seeking to overcome its own obstacles to learning.  The description highlights the difficulty of maintaining consistency in leaders’ ability to reconcile their espoused theory and theory in use in daily work.
  2. Deming WE.  The New Economics.  Cambridge, MA:  Massachusetts Institute of Technology, Center for Advanced Engineering Study; 1993. --  From one of the founders of CQI, a book published just before his death.
  3. Garvin DA.  Building a Learning Organization.  Harvard Business Review.  July-August 1993, 78-91. --  A practical guide to the creation of an organization which is "skilled at creating, acquiring, and transferring knowledge, and at modifying its behavior to reflect new knowledge and insights." See summary.
  4. Kotter JP.  Leading Change:  Why Transformation Efforts Fail.  Harvard Business Review.   March/April 1995, pp 59-67.
  5. Langley GJ, Nolan KM, Nolan TW, Norman CL, Provost LP.  The Improvement Guide: A Practical Approach to Enhancing Organizational Performance.  San Francisco: Jossey-Bass Publishers, 1996.  -- A superb new guide to an overarching model of improvement that combines the best of  “CQI”, “TQM”, “reengineering”, etc.  Excellent reading for the beginner and the expert.
  6. Senge, PM.  The Fifth Discipline:  The Art and Practice of The Learning Organization.  New York:  Doubleday, 1990.  The "textbook" on systems thinking for any group or organization that wishes to have the IQ of the group exceed the IQ of the individuals.
  7. Batalden PB and Stoltz PA-C.  A Framework for the Continual Improvement of Health Care:  Building and Applying Professional and Improvement Knowledge to Test Changes in Daily Work.   Jt Comm Jl  Qual Improv, 1993;19:424-452. -- An important article describing how "knowledge for improvement" plus "discipline-specific knowledge" stimulates continual improvement.
  8. Berwick, DM.   Continuous Improvement as an Ideal in Health Care.   NEJM 1989;320:53-56. -- A classic article that argues for CQI as a more powerful way to improve health care than looking for "bad apples."
  9. Berwick DM, editor.  Eye on Improvement.  A twice-monthly journal which publishes abstracts on continual improvement in health care from a wide range of formal and informal sources.  Reviewers are interdisciplinary and include representatives from medicine, nursing, and health administration. Published by the Institute for Healthcare Improvement, Boston. 
  10. Berwick DM.  A Primer on Leading the Improvement of Systems.  British Medical Journal.  1996;312:619-622. -- A guide to how to make change successfully, citing common pitfalls and how to avoid them.            
  11. Blumenthal, D.  Total Quality Management and Physicians' Clinical Decisions.  JAMA 1993;269:2775-2778. --  Describes industrial quality management science, with special attention to statistical quality control.  Illustrations include improving the accessibility of large amounts of clinical data, as in the intensive care unit and interpreting outcomes over time, as in the management of chronic disease.
  12. Chassin MR.  Part 3: Improving the Quality of Care.  NEJM 1996;335:1060-1063. -- Argument for clinicians to be actively involved in measuring and improving quality of care.
  13. Headrick LA, Neuhauser D.  Quality Health Care.  JAMA.  1995;273:1718-1720.  --  Brief review of progress to date in applications of CQI to clinical medicine.
  14. Kritchevsky SB, Simmons BP.  Continuous Quality Improvement:  Concepts and Applications for Physician Care.  JAMA.  1991;266:1817-1823. --  One of the first articles describing CQI in health care to be published in a "major" journal.
  15. Leading Clinical Quality Improvement.  Healthcare Forum Journal, July - August, 1994: 18-54 -- This issue contains five articles devoted to Leading Clinical Quality Improvement.   James L. Reinertsen, in “The Tyranny of Piecework” addresses the question,  “Does your system have enough central nervous system and backbone to be able to sub-optimize one part so you can optimize the whole?”  Eugene C. Nelson and John H. Wasson contend  that each patient care episode is an opportunity to learn and improve present and future care in “Using Patient-Based Information to Rapidly Redesign Care.”  Lee H. Newcomer presents  Six Pointers for Implementing Guidelines.  H. Gary Pehrson shares lessons from Intermountain Health Care in his article, “Give it Time,” which emphasizes the need to make a long term commitment to attain lasting improvements.  A fifth article is the special insert on “Outcomes Measurement.”
  16. McLaughlin CP, Kaluzny AD.  Continuous Quality Improvement in Health Care:  Theory, Implementation, and Applications, 2nd ed.  Gaithersburg, MD:  Aspen Publishers, 1999. --  For those who wish to dig deeper, this recent, well-written book is a good overview of the state-of-the art in continual improvement in health care.
  17. The President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry.  Quality First:  Better Health Care For All Americans. Washington, D.C.:  U.S. Government Printing Office, 1998.  Available by writing the printing office, Superintendent of Documents, Mail Stop:  SSOP, Washington, D.C.,  20402-9328.  ISBN 0-16-049533-4.   – Recommendations to improve the U.S. health care system  “to continuously reduce the impact and burden of illness, injury, and disability and to improve the health and functioning of the people of the United States.”  
  18. Agency for Health Care Quality and Research fact sheet on Improving Health Care Quality. Quality problems are reflected  today in the wide variation in use of health care services, the under-use and overuse of some services, and misuse of others. Improving the quality of health care and reducing medical errors are priorities for the Agency for Healthcare Research and Quality.
  19. American Society for Quality, Health Care Division.
  20. Institute for Healthcare Improvement
  21. National Coalition on Health Care (NCHC)
  22. National Institute of Standards and Technology (NIST) on Health Care
  23. Baldrige National Quality Award
  24. American National Standards Institute's Healthcare Informatics Standards Board (ANSI HISB)
  25. VA National Center for Patient Safety <
  26. Barriers to implementation of continuous quality improvement

 UNIT 2:

  1. Agency for Health Care Quality and Research.
  2. American Society for Quality, Health Care Division
  3. Institute for Healthcare Improvement
  4. National Coalition on Health Care (NCHC)
  5. National Institute of Standards and Technology (NIST) on Health Care
  6. Baldrige National Quality Award
  7. American National Standards Institute's Healthcare Informatics Standards Board (ANSI HISB)
  8. Redick EL.  Applying FOCUS-PDCA to solve clinical problemsDimens Crit Care Nurs 1999 Nov-Dec;18(6):30-4.  This article describes one method of step-by-step problem solving and how to apply it to a clinical situation
  9. Hayes SK, Childress DM.  Fairy tales of storyboarding.  J Nurses Staff Dev 1999 Nov-Dec;15(6):260-2.  Tutorial on how to create a storyboard. 
  10. Bibliography on creating story boards. 
  11. For more on patient safety, click here.
  12. Madison (WI) Area Quality Improvement Network
  13. Formulary
  14. Quality in Europe
  15. Pubmed Medline With Clinical Search Filters
  16. British Medical Journal Abstracts
  17. Online Quality Resources Guide Highlight Page
  18. The Online Quality Resources Guide
  19. Other Quality-related Email Lists
  20. The American Productivity and Quality Center (APQC)
  21. QualiNet
  22. Association for Quality and Participation (AQP)
  23. The Quality Assurance Institute
  24. The USDA's TQM Website
  25. Quality Sites on the Web
  26. Initiative Center of the Negev
  27. Quality Online Forum's Website
  28. Los Alamos National Laboratory's Quality and Planning Website
  29. The International Quality & Productivity Center
  30. University of Texas Quality Center
  31. International Organization for Standardization
  32. American National Standards Institute
  33. The Massachusetts Council for Quality Website
  34. The Process Improvement Website
  35. East Carolina University's
  36. The Philip Crosby Website
  37. OnQual
  38. ISO9000/QS9000 Website
  39. Quality Digest Magazine's Website
  40. The American Association of School Administrators' (AASA) Total Quality Network Website
  41. The Quality Management Principles Website
  42. The American Productivity and Quality Center (APQC)
  43. The Management of Technical Organizations -


  1. Read about attribution theory More►
  2. Read more about social support.  See how orientation of informal organizations and groups can be measured and identified.
  3. Read more about innovation diffusion. 
  4. Read more about media advocacy for preventing teen violence.  See a  manual for public health media advocacy.
  5. Read examples of how the military is using re-engineering to solve health care issues.  See if it works.  See introduction to re-engineering by a consulting agency
  6. See Jim Grizzell's page on behavioral change theories.
  7. See various behavioral theories applied to understanding physical activity.

 UNIT 4:  

1.       Read about how a dyad team of nurse case manager and social worker improve discharge planning.  
2.       Bibliography on effectiveness of clinical teams of nurses and physicians.
3.       Bibliography on effectiveness of improvement teams

 UNIT 5:  

  1. Classifying and monitoring medication errors. One way of measuring severity of problems is through classification systems.  Here are examples of how to classify medication errors.
  2. Studies of use of pharmacy data to measure severity of patients' illness  Pharmacies have rich databases about nature of illness of their patients.   Here are studies that show you how to use that data to understand outcomes of care.
  3. Risks of risk assessment Studies discussing accuracy of risk assessment technologies.
  4. Nursing severity indices Studies of severity indices developed from the perspective of nursing
  5. Community wide measurement of quality Uses severity indices to evaluate performance of clinicians through out a community (e.g. Cleveland Quality Choice project)
  6. To review the abstract of the latest papers on Disease Staging click here.
  7. For the abstracts of the latest studies on Patient Management Categories click here.  For use of ambulatory care databases, click here.
  8. For abstracts of latest papers on Computerized Severity Index click here.
  9. To review abstracts of the latest publications related to APACHE click here
  10. For abstract of the latest papers on Medisgroup click here
  11. For a full text article on how to assess risks in substance abuse treatment programs click here.  



  1. c Charts  A short and no-nonsense introduction to use of charts for assessment of conformity to standards. From The Quality Tools Cookbook.
  2. Common Control Chart Cookbook Prof. Sid Sytsma and Dr. Kitty Manley provide detailed instructions to different charts including p-chart.  
  3. Control Chart Basics Skymark corporation discusses how to interpret control charts.
  4. Control Chart Selection Flow Chart This flow chart tells you which chart is right.  Risk adjusted control charts are not included.
  5. Control charts measure uncertainty Thomas Pyzdek argues that statistics starts with assumption of ignorance.  He follows with why chart data?
  6. Introduction to and Interpretation of Control Charts Prof. Sid Sytsma gives an introduction to control chart and how to recognize processes out of control.   See also np Charts and p Charts.
  7. Presentation on Control Charts J. Sullivan slides on control charts.
  8. u Charts U Charts are used when it is not  possible to have an inspection unit of a fixed size.  This page provides an introduction to u-charts.


  1. For more on standard deviations click here
  2. Prof. Sid Sytsma and  Dr. Kitty Manley from Ferris State University discuss construction of X-bar chart in their "Common Control Chart Cookbook"
  3. Marilyn & Robert Hart discuss the difference between 2 standard and 3 standard deviation away from the mean. 
  4. John Flaig discusses when should you use mean of observations as opposed to individual observations
  5. Annotated bibliography of using control charts to improve health care
  6. Calculate area under student-t distribution values. 

 UNIT 8:  

  1. Annotated bibliography of use of Shewhart's Control Chart (XmR charts)
  2. Iglewicz and Hoaglin write about how to detect and correct for outliers.
  3. Use of moving average chart in analysis of stock market.
  4. Wheeler discusses how much precision is necessary for XmR charts
  5. DynaWise Charts produces statistical process control charts for health care.
  6. Process Control Solutions products includes XmR charts
  7. Introduction to XmR chart in Quality Library
  8. Peter Baxter's introduction to XmR chart
  9. Introduction to control charts including XmR charts
  10. Control chart wizard for single data per time period.
  11. iSixSigma - Six Sigma Quality Resources
  12. Breakthrough Management Group
  13. Juran institute
  14. Quality magazine
  15. The purpose of XmR chart is insight

 UNIT 9:  

  1. The collected work of John Tukey 
  2. Tukey writes about exploratory data analysis
  3. Box and whisker plots or see related web sites.
  4. Who was Tukey?
  5. The Internet Glossary of Statistical Terms
  6. Tukey's writing in health care.

 UNIT 10:  

  1. Expert Panel Report.  Guidelines for the diagnosis and management of asthma.  National Institute of Health, Publication number 92-3091, 1992.
  2. Boggs P, Hayati, Washburne W, Wheeler D. Using statistical process control charts for the continual improvement of asthma care. Joint Commission Journal on Quality Improvement 1999;25:163-81.
  3. Gibson PG, Wlodarczyk J, Hensley MJ, et al. Using quality-control analysis of peak expiratory flow readings to guide therapy for asthma. Ann Intern Med 1995;123:488-92.
  4. Headrick L, Neuhauser D, Melnikow J.  Asthma health status. Ongoing measurement in the context of continuous quality improvement.  Med Care. 1993 Mar;31(3 Suppl):MS97-105.
  5. Solodky C, Chen H, Jones PK, Katcher W, Neuhauser D. Patients as partners in clinical research: a proposal for applying quality improvement methods to patient care. Med Care. 1998 Aug;36(8 Suppl):AS13-20.
  6. Neuhauser DV, Jean-Baptiste R, Solodky C.   Neighborhood care partners (NCP): a teaching case. Qual Manag Health Care. 2001 Spring; 9(3): 66-70.
  7. Boggs P, Wheeler D, Washburne W, Hayati F. The peak expiratory flow rate control chart in asthma care: chart construction and use in asthma care. Ann Allergy Asthma Immunol 1998; 81:552-62
  8. Benneyan JC. Number-between g-type statistical quality control charts for monitoring adverse events. Health Care Management Science. 2001 Dec; 4(4): 305-18.
  9. Benneyan JC. Performance of number-between g-type statistical control charts for monitoring adverse events. Health Care Management Science. 2001 Dec; 4(4): 319-36. 
  10. List of online sites for construction of g-charts
  11. Annotated bibliography for using control charts in management of asthma.  See also use of statistical process control tools in asthma care.
  12. Annotated bibliography for what is relapse.  More on impact of family drug courts.  

This page is part of the course on Quality / Process Improvement, the section on "Link to Others." It was last edited on 05/03/2015 by Farrokh Alemi, Ph.D.  Copyright protected.