J Clin Outcomes Manage
The application of statistical process control to cataract surgery
Jatla KK, Enzenauer RW
Abstract Objective: To apply statistical process control (SPC) techniques to evaluate 3 components of the phacoemulsification cataract surgery procedure. Design: Retrospective chart review. Methods: We analyzed 180 cataract surgeries performed by 6 cataract surgeons (3 “high-volume” and 3 “low-volume” surgeons). Surgical parameters evaluated were phacoemulsification time (seconds), phacoemulsification power (mJ), and surgical time (minutes). Data were analyzed using the QI Analyst software package to generate SPC run charts and histograms. Results: Our results did not reveal a statistically significant difference in mean phacoemulsification time (P = 0.814) or phacoemulsification power (P = 0.115) between high- and low-volume cataract surgeons. The difference in surgical times between high- and low-volume surgeons was statistically significant (P < 0.001). Visual inspection analysis of the SPC charts revealed more variability for both phacoemulsification time and power among the high-volume surgeons. Conclusions: Elements of the cataract surgery procedure can be evaluated using SPC methodology. Eye surgeons should be encouraged to use SPC charting techniques to analyze variability in ophthalmologic procedures with the ultimate goal of producing better outcomes.
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