Value of small sample sizes in rapid-cycle quality improvement projects

Etchells, E., Ho, M., & Shojania, K. G. (2015). Value of small sample sizes in rapid-cycle quality improvement projects. BMJ quality & safety, bmjqs-2015.

Abstract

Quality improvement initiatives can become bogged down by excessive data collection. Sometimes the question arises —are we doing an adequate job with respect to a recommended practice? Are we complying with some guideline in at least X% of our patients? The perception that one must audit large numbers of charts may present a barrier to initiating local improvement activities. The model for improvement and its Plan–Do–Study–
Act (PDSA) cycles typically require frequent data collection to test ideas and refine the planned change strategy. The
perception that data collection must involve many patients can lead to insufficiently frequent PDSA cycles.1 In this
review, we demonstrate the important contributions that small samples can make to improvement projects, including local audits, PDSA cycles and during broader implementation and evaluation.

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