TY - JOUR T1 - Modern measurement for a modern health service JF - Quality in Health Care JO - Qual Health Care SP - 199 LP - 200 DO - 10.1136/qhc.9.4.199 VL - 9 IS - 4 AU - P M Wilcock AU - R G Thomson Y1 - 2000/12/01 UR - http://qualitysafety.bmj.com/content/9/4/199.abstract N2 - Modern approaches to improvement in health care need modern approaches to measurement. Our traditional use of matrices of retrospective data has been described as like “trying to drive a car by looking through the rear view mirror”.1 Statistical process control tools appear to have much to offer despite the concerns expressed about using techniques taken from industry.2–5 In this issue of Quality in Health Care Boëlle et al lift the lid on the use of control charts in health care and give us a peek inside.6 This commentary attempts to lift the lid a little further to explain the importance of the principles underpinning their use and to provide some further insights into their value for taking the next step—that is, actively to improve care. Whenever we measure such data as the average length of stay each quarter, monthly waiting times to admission, or frequency of adverse events in anaesthetic processes we can be sure of one thing—the results will change over time because of natural variation. However, our own natural inclination is to respond to individual data points as soon as we see them and many a management memo has been written exhorting staff to “do something about it”, even though “it” may be due to random causes. Control charts are graphs that can take the uncertainty out of decision making through the analysis of relationships between data points plotted over time. They offer a … ER -