CH 8

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Chapter 8

Health care facilities must conform to certain standards in submitting bills to Medicare/Medicaid for
processing. The number of bills with errors and the number sampled are shown in table. Construct an
appropriate control chart and comment on the performance of the billing department .Revise the
control limits , if necessary, assuming special causes for out of control points . Comment on the
capability of the department.

Observations Bills Number


with Sampled
errors
1 8 400
2 6 400
3 4 400
4 9 400
5 7 400
6 5 400
7 5 300
8 7 300
9 4 300
10 15 300
11 6 300
12 7 300
13 4 300
14 3 300
15 5 300
16 8 300
17 11 500
18 13 500
19 8 500
20 7 500
21 8 500
22 4 500
23 3 500
24 7 500
25 6 500
Chapter 8

CODE FOR p-CONTROL CHART:


bills_with_errors<-c(8,6,4,9,7,5,5,7,4,15,6,7,4,3,5,8,11,13,8,7,8,4,3,7,6)

number_sampled<-c(400,400,400,400,400,400,300,300,300,300,300,300,300,300,300,300,500,500,500,500,500,500,500,500,500)

table3<-data.frame(bills_with_errors,number_sampled)

print(table3)

pchart<-with(table3,qcc(table3$bills_with_errors,table3$number_sampled,type="p",data.name="chart_for_errors"))

RESULT:

COMMENTS:
Here point 10 is outside the control limit. So we can say that the process is out of control. So to make process in control the special cause
for the point 10 needs to be investigated and has to be eliminated. So assuming that the special cause for point 10 has been found and has
been eliminated the revise control chart is plotted by eliminating point 10.
Chapter 8

CODE FOR REVISE p-CONTROL CHART:


bills_with_errors2<-bills_with_errors[-c(10)]

number_sampled2<-number_sampled[-c(10)]

table4<-data.frame(bills_with_errors2,number_sampled2)

pchart<-with(table4,qcc(table4$bills_with_errors2,table4$number_sampled2,type="p",data.name="chart_for_errors_revised"))

RESULT:

COMMENTS:
The average proportion of errors is 0.01614 after the revision of the chart. For the numbered sample of 500 if we assume target of error t
. ∗( . )
be 0 then the standard deviation will be = 0.00562

.
And Z = = 2.86 . So it in 2.86 standard deviation away from the mean so it is not feasible to expect error free bills.
.
Chapter 8

The number of dietary errors is found from a random sample of 100 trays chosen on a daily basis in a
health care facility . The data for 25 such sample s are chosen in table.

a) Construct an appropriate control chart and comment on the process.


b) How many dietary errors do you predict if no changes are made in the process?
c) Is the system capable of reducing dietary errors to 2 on average per 100 trays if no change are
made in the process?
Sample Number
Number of
dietary
errors
1 9
2 6
3 4
4 7
5 5
6 6
7 16
8 8
9 7
10 9
11 3
12 6
13 10
14 8
15 8
16 7
17 6
18 4
19 12
20 7
21 6
22 8
23 6
24 8
25 5
Chapter 8

CODE FOR c-CONTROL CHART:


sample<-as.integer(rep(100,25))

errors<-c(9,6,4,7,5,6,16,8,7,9,3,6,10,8,8,7,6,4,12,7,6,8,6,8,5)

table<-data.frame(sample, errors)

cchart<-with(table,qcc(table$errors,table$sample,type="c",data.name="dietary_errors"))))

RESULT:

COMMENT:
Here point 7 is outside the control limit. So we can say that the process is out of control. So to make process in control the special cause for
the point 10 needs to be investigated and has to be eliminated. So assuming that the special cause for point 7 has been found and has been
eliminated the revise control chart is plotted by eliminating point 7.

CODE FOR REVISED c-CONTROL CHART:


sample2<-as.integer(rep(100,24))

errors2<-errors[-c(7)]

table2<-data.frame(sample2,errors2)

cchart<-with(table2,qcc(table2$errors2,table2$sample2,type="c",data.name="dietary_errors_revised"))
Chapter 8

RESULT:

COMMENTS:
Above mention in the revise c-chart after the elimination of the special cause corresponding to point 7.

b) If no changes are made then the dietary errors will be 6.875.

c) For the average dietary error of 6.875 per 100 trays, P(x≤2) = 0.0203 by Poisson distribution. So it is no feasible to achieve this level with
the current system.

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