Run Chart

A Run Chart is a line graph that displays a series of data points over a specified period time to provide information about trends, patterns, and variations in a process.
Resource Type: 
  • Guide
Topic(s): 

    REFERENCES

     

    Bassard, M., Ritter, D.(2010). The Memory Jogger 2. Tools for Continuous Improvement and Effective Planning.Second Edition.Salem, NH: GOAL/QPC

    Scoville, Robert, Ph.D. “Run Chart Tool.” Institute for Healthcare Improvement. N.p., 30 May 2016. Web. Retrieved: 17 May 2017.

    Sollecito, W. A., Johnson, J. K. (2013). Continuous Quality Improvement in Health Care Fourth Edition.Burlington, MA: Jones & Bartlett Learning.

    Spath, P. L. (2013). Introduction to Healthcare Quality Management, Second Edition.Chicago, IL: Health Administration Press.

    Tam, R.Handbook for Basic Process Improvement.10 June 1996. Website retrieved: 17 May 2017

    White, S. V. (2012). Q Solutions: Essential Resources for the Healthcare Quality Professional.  Quality and Performance Improvement. Third Edition.Glenview, IL; National Association for Healthcare Quality

    Permission to use by IHI.org.  Run Chart Template  v.2.0 (5-30-2016)  Developed by Richard Scoville, Ph.D. http://www.ihi.org/resources/Pages/Tools/RunChart.aspx

    REFERENCES

    How to Use Run Chart:

    Run Charts Are Used to:

    • Monitor performance of a process to detect trends, shifts, or cycles
    • Compare a performance measure before and after implementation of a solution to measure its impact
    • Focus attention on vital changes in the process
    • Track information for predicting trends

    Materials You'll Need:

    • Data points (at least 20-25 data points)
    • An Excel spreadsheet or other electronic tool that can display data
      OR
    • Graph paper
    • Pencils/pens

    How to Use Run Chart:

    Decide

    Decide on the process to be measured.

    Data

    Gather data.

    Graph

    Create a graph with a vertical line (Y axis) and a horizontal line (X axis).
    Diagram of X and Y axes showing what is measured and when.
    Understanding X and Y axes in quality measurement graphs.

    Label the Y-Axis

    Label the Y-axis (vertical axis) with the topic you are measuring (e.g. minutes, hours, patient cycle time through clinic, number of days to the next available appointment, percentage of “No Shows”).

    Determine Y-Axis Scale

    Determine the Y-axis scale. Be sure to include the full range and add approximately 1.5 times the range of data on either end. Note: If you are creating a dashboard type report or visual with multiple run charts, consider using the same scale for all charts. By using the same scale, your visual will more accurately represent the measure’s status when compared to other measures.

    Label the X-Axis

    Label the X axis (horizontal axis) with the time or sequence scale (e.g. date, month, quarter, hour, patient #, etc).

    Plot Data

    Plot the data values to the X axis.

    Draw Connecting Lines

    Draw lines to connect the points.

    Example: Patient Cycle time on one day in a Medical Clinic

    Line chart showing patient cycle time across 14 patients with individual values.
    Patient cycle time across 14 patients without mean reference line.

    Calculate Mean or Median

    Calculate the mean (average) or the median (midpoint) of the data points and draw a horizontal line through the chart.

    • To calculate the mean, add the total of all data points and then divide by the number of data points.

    • (50+65+45+40+45+75+80+60+95+100+105+95+90+100) = 1045
    • 1045/14 = 74.6

    Example: Patient Cycle Time run chart using the mean as its center line

    Line graph of patient cycle times with a green horizontal mean line at 74.6 minutes.
    Patient cycle time with mean line indicating overall performance level.

    CHECK FOR PROCESS STABILITY

    • Use the Run Chart to determine if a process is stable, or if there are special circumstances which cause a variation in the process.
    • Signals of non-random patterns include:
    • Shift - 6 or more consecutive points, either all above or below the mean.
    • Trend - 5 or more consecutive points all going up or all going down.
    • Run - A sequence of consecutive points that lie on the same side of the mean line. Ignore the points that are exactly on the line.
    • Example: Patient Cycle Time with Signals
    Line graph demonstrating run chart rules with data patterns highlighted.
    Identifying statistical signals in run charts using rule-based patterns.

    Improving the Process

    Study Data and Determine Causes

    Study the data to find patterns and to determine the causes. Ask the following questions:

    • Is the recent data within the usual range?
    •  Is there a daily, weekly, monthly or yearly pattern?

    NOTE: The example of Patient Cycle time was collected on only one day. To better understand cycle times, collect data for at least a week.

    Patient cycle time baseline chart from January to March 2016 with a green mean line.
    Baseline patient cycle time measurements before intervention.

    The following variables could be affecting your data: 

    • Types of appointments
    • Number of staff present
    • Walk-ins and No-shows
    • Technology issues

    Determine Alterations

    Determine which areas or parts of the process need to be altered.

    Utiliza a Process Improvemenent Methology

    Utilize a Process Improvement Methodology such as PDSA to make improvements.

    Note Corrections

    After a correction is made to the process, note that on your Run Chart and continue to collect data to see if an improvement has taken place. NOTE: Redraw the Median/Mean line ONLY when a Significant change has been made to the process.
    Line graph of patient cycle time before and after a vertical dashed line indicating intervention.
    Patient cycle time before and after a process intervention.

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