Benchmarking & Clinician Profiles
Assigned Reading
Risk adjusted practice profiling
Read►
Assignment
Question 1:
In the following questions assume that we have followed two clinicians, Smith
and Jones, and constructed the decision trees in Figure 1.
Atoosa's Video►
Figure 1: Practice Patterns of Dr. Jones and Smith
 What is the expected length of stay for each of the clinicians?
 What is the expected length of stay for Dr. Smith if he were to take care of
patients of Dr. Jones?
 What is the expected length of stay for Dr. Jones if he were to take of patients
of Dr. Smith?
Question 2: The following table shows the
observed and expected length of stay for 30 patients.
Data►

Use paired
comparison of means to test that the expected and observed length of stay are
the same.

Assuming normal distribution of the length of stay, use riskadjusted
control chart to plot the data. Make sure that control limits are derived
from the expected values and observations are contrasted to these
limits. This analysis can be done using Tukey or XmR and you
need to select which chart produces tighter control limits.
The conclusions you arrive at based on (a) paired
comparison of expected and observed length of stay and (b) the
riskadjusted control charts should be the same if in both situations we
were calculating the control limits from the same number of cases. Are they?
tTest: Paired Two Sample for
Means 





Expected 
Observed 
Mean 
4.8 
3.9 
Variance 
2.10 
0.64 
Observations 
30 
30 
Pearson Correlation 
0.10 

Hypothesized Mean Difference 
0 

df 
29 

t Stat 
3.11 

P(T<=t) onetail 
0.00 

t Critical onetail 
1.70 

P(T<=t) twotail 
0.00 

t Critical
twotail 
2.05 

Presentations
How to provide feedback to clinicians
Slides►
Listen►
Narrated lecture requires use of Flash►
 Practice profiling PubMed►
 Importance of risk adjustment in measuring performance in primary care PubMed►
Prepared by
Farrokh
Alemi, Ph.D.
This page is part of the course on
Statistical
Process Improvement 