Jay Arthur Blog

Improvement Insights Blog

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Ask Jay – What Kind of Chart Should I Use?

People still seem to be confused about what kind of Quality Improvement chart to use. Here’s the short and simple answer:

Posted by Jay Arthur in Ask Jay, Jay Arthur Blog.

NAHQ NEXT 2020 HQ Showcase – Jay Arthur

If you’re a registered NAHQ Next 2020 attendee, you can view Jay Arthur’s showcase until October 31, 2020.

1. Click on the link below.



2. Click on the NAHQ Next top banner to log in. It will take you to the page below. Log in with your name and email address:



3. Once you’re logged in, visit the On-Demand Sessions and scroll to the very bottom to view Jay’s session, “Zero Harm and the Trillion Dollar Prescription.”


Posted by Jay Arthur in Agile Lean Six Sigma, Healthcare, Jay Arthur Blog, QI Macros.

COVID-19 Cases by Type of Facility

The New York Times published a list of cases by facility. I tweaked it to get Pareto Charts of the biggest problems. Nursing homes and rehab facilities were 64% of the total, then prisons and food processing (e.g., beef, pork, poultry, etc.).

cases by type of facility

facility related cases by state

Posted by Jay Arthur in Agile Lean Six Sigma, Jay Arthur Blog, QI Macros.

Let’s Work Together

This is a fun thing we did last week. While Watching the movie “Forrest Gump,” Jay heard this song and had the idea that this song is particularly applicable to our current situation. Several of the people that work for QI Macros are musicians, so we tried to do something fun while we’re working remotely. This was recorded in 4 separate homes and then assembled and arranged by Nicholas. We hope you enjoy it:

Posted by Jay Arthur in Jay Arthur Blog.

U.S. Deaths by Age Group as of 4/24/2020

People over age 55 account for 92% of COVID-19 Deaths (data from CDC). Sweden is using similar data to leave the country open for most citizens while asking seniors to stay at home. How do we reopen the economy? Self-quarantine seniors; let everyone else get back to work.

us covid deaths by age group 65 plus

Here’s the 2019-2020 Influenza (i.e., Flu) deaths. Again, seniors are 83.5% of deaths. The flu death rate is about 1 per 1,000. COVID-19 death rate is 1-2 per 100, perhaps lower in people under the age of 55 and higher for those over age 55.

Countermeasure: Self-quarantining seniors will help flatten the curve and prevent overwhelming healthcare.

Posted by Jay Arthur in Healthcare, Jay Arthur Blog, QI Macros.

Colorado COVID-19 Cases and Deaths in Control Charts

While most COVID-19 charts show cumulative cases and deaths, I wondered what would happen if we turned the cumulative data into a daily data and plotted it as a control chart. It is possible to use c or XmR charts for this purpose. Process changes chosen based on runs and trends in the data.

co covid cases c chart

Daily new cases still unstable, but hovering around 339/day. Cases began to rise 3/18. Potentially leveling off 3/26. the date of state “stay-at-home” order.

  co covid cases c chart

Daily deaths still unstable, but hovering around 12/day. Deaths began rising 3/21, but appear to be stabilizing.  Significant spike on 4/2, root cause unknown.

Posted by Jay Arthur in Jay Arthur Blog, QI Macros.

COVID-19 Paramedic Dashboard 2020

One of our QI Macros users offered to share his dashboard of paramedic response during the Seattle area response to COVID-19. His team transported the first COVID patient in America. As you can see, turnaround times (TAT) at the hospital averaged 30 minutes and temperatures spiked in transported patients.

covid paramedic dashboard 2020

Posted by Jay Arthur in Healthcare, Jay Arthur Blog, Lean, QI Macros.

How Crisis Affects U.S. Healthcare Workers

Back in 2002, thousands of miles from New York City, I worked with a hospital in Oregon. I was amazed to find that they had staffing data from 9/11 about the up and down for that month. As you can see in this X Chart, absenteeism (understaffing) was lower for each of the four following days, 9/12-15, and then recovered. I have noticed this pattern with COVID-19 as well: a week of paralysis followed by a return to normal. Unfortunately, healthcare workers haven’t had the luxury of downtime when dealing with the new crisis.
2001 hospital staffing downturn

So don’t be surprised if crisis and uncertainty cause you or someone you know to hit the pause button.

Posted by Jay Arthur in Healthcare, Jay Arthur Blog, Lean, QI Macros.

Reducing Blood Sample Over-Collection

At the ASQ Lean Six Sigma Conference in Phoenix this week, Katie Castree with Accumen presented an excellent improvement story about reducing over-collection of blood tubes in a hospital. Here’s the story:

Baseline: 317 extra tubes of blood collected every day (115,705/year)

extrat tubes baseline

93% of tubes were not used (clinicians thought it was much higher and resisted changing)

not used percentage

Most of the unused tubes were collected in the Emergency Department (focus on the ED, not the entire hospital).

extrat tubes pareto

After the countermeasure (not collecting tubes unnecessarily), extra tubes dropped from 317 per day to 118 per day saving $12,335/year and 0.27 FTEs. Over time, extra tubes dropped to only 84 per day, a 74% reduction.

Posted by Jay Arthur in Agile Lean Six Sigma, Healthcare, Jay Arthur Blog, QI Macros, Six Sigma.

When are bar charts dangerous?

Answer: Almost always.

  • When everything is presented in a bar chart, everything looks the same. And before long, everyone forgets what they’re looking at. Dan Roam

Bar charts always remind me of a Jack-O-Lantern with bad teeth.


Bar charts are one of the most misused charts. The most common mistake is using bar charts for time-series data (i.e., dates):

bar chart time series

Bar charts are best used for categories—types of defects, objects, or whatever. Even so, the bars are often in a random order which makes distinguishing the important from the unimportant pretty difficult. Simply sorting the bars into a descending order makes them easier to analyze.

Posted by Jay Arthur in Jay Arthur Blog.