presenting data & standardized infection ratios tim wiemken phd mph cic assistant professor of...
TRANSCRIPT
![Page 1: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/1.jpg)
Presenting Data&
Standardized Infection Ratios
Tim Wiemken PhD MPH CICAssistant Professor of Medicine
Assistant Director of Epidemiology and Biostatistics
University of Louisville
School of Medicine, Division of Infectious Diseases
Clinical and Translational Research Support Center
Phone: 502.852.4627
www.ctrsc.net
![Page 2: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/2.jpg)
Pre-Presentation Comment
• Do not collect any data you do not plan to use (unless your boss tells you to).
![Page 3: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/3.jpg)
Pre-Presentation Comment
• What constitutes ‘use’?1. Displaying somewhere other than just a
meeting
2. Preliminary to a follow-up to collect data that will be used
3. Education
4. Targeted prevention
5. Surveillance (only if you educate with it!)
![Page 4: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/4.jpg)
Overview
• What makes a good report?• How to choose a chart• Components of good charts• Tips for reports• Standardized Infection Ratios
![Page 5: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/5.jpg)
Overview
• What makes a good report?• How to choose a chart• Components of good charts• Tips for reports• Standardized Infection Ratios
![Page 6: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/6.jpg)
What Makes a Good Report?
The catch all answer – it depends!
There are some key ideas you should think about when preparing any report
![Page 7: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/7.jpg)
What Makes a Good Report?
Create reports that can be USED, not just looked at.
…more later
![Page 8: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/8.jpg)
What Makes a Good Report?
1. How much time do you have?
![Page 9: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/9.jpg)
What Makes a Good Report?
2. Who is your audience?• How sophisticated are they?• What do they already know?• Remember that people think and speak differently
![Page 10: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/10.jpg)
What Makes a Good Report?
3. Why are you giving the presentation?• To show data? (I hope not!)• To provide the status of something?• To prove your worth?• To affect change?• To get someone fired?
![Page 11: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/11.jpg)
What Makes a Good Report?
Each of these helps you decide one key piece of information:
What do you NEED to present?
![Page 12: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/12.jpg)
What Makes a Good Report?
A few rules:
1. Never present more than you need to present.
![Page 13: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/13.jpg)
What Makes a Good Report?
A few rules:
1. Never present more than you need to present.
2. Never present less than you need to present.
![Page 14: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/14.jpg)
What Makes a Good Report?
A few rules:
1. Never present more than you need to present.
2. Never present less than you need to present.
3. Keep it as short as possible.
![Page 15: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/15.jpg)
What Makes a Good Report?
Therefore, focus on what is necessary to meet your goals.
![Page 16: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/16.jpg)
What Makes a Good Report?
Yeah, so smarty pants, what is necessary?
![Page 17: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/17.jpg)
What Makes a Good Report?
IT DEPENDS!
![Page 18: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/18.jpg)
What Makes a Good Report?
Although what is needed depends on how much time you have, your audience, and your goal:
1. It is rarely OK to present raw data by itself:
![Page 19: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/19.jpg)
What Makes a Good Report?
Infection Prevention and Control Report, May 2012:
CLABSI: 5
VAP: 4
CAUTI: 7
MRSA: 10
![Page 20: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/20.jpg)
What Makes a Good Report?
Infection Prevention and Control Report, May 2012:
CLABSI: 5
VAP: 4
CAUTI: 7
MRSA: 10
![Page 21: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/21.jpg)
What Makes a Good Report?
Infection Prevention and Control Report, May 2012:
This is only slightly better.
![Page 22: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/22.jpg)
What Makes a Good Report?
Although what is needed depends on how much time you have, your audience, and your goal:
2. It is rarely OK to present significant amounts of text
– E.g. policies, procedures, etc.
![Page 23: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/23.jpg)
What Makes a Good Report?
2. It is rarely OK to present significant amounts of text
– No one wants a six page policy handed to them in a meeting to review.
– It will not get reviewed (at least not well).– Send these out early… and many times.
![Page 24: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/24.jpg)
What Makes a Good Report?
The Holy Order of Data Quality (worst to best).
1. Text
2. Raw numbers
3. Raw rates
4. Tables of chronological numbers or rates
5. Charts (hierarchy of charts later…)
6. Charts with #4
7. Charts with #1, #3, and more fun statistics
![Page 25: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/25.jpg)
Overview
• What makes a good report?• How to choose a chart• Components of good charts• Tips for reports• Standardized Infection Ratios
![Page 26: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/26.jpg)
Choosing a Chart
• Charts– Numbers alone are bad
![Page 27: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/27.jpg)
Choosing a Chart
• Charts– Visual depiction is easier to quickly
comprehend
![Page 28: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/28.jpg)
Choosing a Chart
• Charts– Visual depiction is easier to quickly
comprehend– Choosing the correct chart is extremely
important
![Page 29: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/29.jpg)
Choosing a Chart
• Charts– Visual depiction is easier to quickly
comprehend– Choosing the correct chart is extremely
important– Some charts show trends or comparisons in
data
![Page 30: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/30.jpg)
Choosing a Chart
• Charts– Visual depiction is easier to quickly
comprehend– Choosing the correct chart is extremely
important– Some charts show trends or comparisons in
data– The best chart does not have to be explained
![Page 31: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/31.jpg)
Choosing a Chart
• Most common/useful types of charts
1. Pie
2. Bar
3. Line
4. Radar
![Page 32: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/32.jpg)
Choosing a Chart
• Most common/useful types of charts
1. Pie
![Page 33: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/33.jpg)
Choosing Charts
• Pie– Less appropriate than one would think– Categorical data that comprise of portions that
add to 100% – Never use 3D pie charts – Do not use a pie chart if you have a lot of
categories
![Page 34: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/34.jpg)
Choosing Charts
• Pie– Do not use a pie chart if you have a lot of
categories
![Page 35: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/35.jpg)
Choosing Charts
• Pie
“Use a pie chart when you don’t have anything to say”
- Dr. Julio Ramirez
![Page 36: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/36.jpg)
Pie Charts
![Page 37: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/37.jpg)
No!
60.0%20.0%
15.0% 5.0%
SurgeryAnesthesiaMedicineCardiac
![Page 38: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/38.jpg)
Choosing a Chart
• Most common/useful types of charts
2. Bar
![Page 39: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/39.jpg)
Choosing Charts
• Bar– Snapshots of data [rates in one month]– Comparing data across different categories– Never use 3D charts unless you have a 3rd
dimension!
![Page 40: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/40.jpg)
Bar Charts
![Page 41: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/41.jpg)
No!
Surgery
Anesthesia
Medicine
Cardiac
0% 10% 20% 30% 40% 50% 60%
![Page 42: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/42.jpg)
Bar Charts
• Is it ever appropriate to use 3D charts?
![Page 43: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/43.jpg)
Yes! (Really?)
![Page 44: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/44.jpg)
Choosing a Chart
• Most common/useful types of charts
3. Line
![Page 45: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/45.jpg)
Choosing a Chart
• Line – Longitudinal data (data over time)– Contiguous points
![Page 46: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/46.jpg)
Choosing a Chart
• Line – Longitudinal data (data over time)– Contiguous points– Rates, Counts, etc. by Month/Quarter/Year
• Run charts• Statistical Process Control charts
![Page 47: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/47.jpg)
Choosing a Chart
• Run charts– Use when you have few time periods (e.g.
<25 months).
![Page 48: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/48.jpg)
Choosing a Chart
• Run charts– Anatomy
• Center Line / Median –represents the median of all of the data points.
• X-axis –represents the time period of interest (days, weeks, months, quarters, years).
• Y-axis –represents the scale of the plotted data points (e.g. rate or count of infection).
• Data points – the actual data values.
![Page 49: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/49.jpg)
Choosing a Chart
• Run chartsY-axis (Rate)
X-axis (Month)
Center Line (Median)
Data Points (<25)
![Page 50: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/50.jpg)
Choosing a Chart
• Run charts– Use
• Use to identify when the data are different than you expect (for better or worse) through detecting abnormal variation
![Page 51: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/51.jpg)
Choosing a Chart
• Run charts– Rules for abnormal variation
1. Seven or more consecutive points on either side of the Center Line (median).
2. Five or more consecutive points increasing or decreasing.
3. Fourteen or more consecutive points alternating up and down.
![Page 52: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/52.jpg)
Choosing a Chart
• Run charts
Rule 17 points below median
Rule 25 consecutive points increasing
![Page 53: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/53.jpg)
Choosing a Chart
• Statistical Process Control (SPC) charts– Use when you have many time periods (e.g.
≥25 months).– These are much better than run charts.
![Page 54: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/54.jpg)
Choosing a Chart
• SPCcharts– Anatomy
• Center Line / Mean–represents the average of all of the data points.
• X-axis –represents the time period of interest (days, weeks, months, quarters, years).
• Y-axis –represents the scale of the plotted data points (e.g. rate or count of infection).
• Data points – the actual data values.• Standard deviation lines (control limits) – represent 1,
2 or 3 standard deviations on each side of the center line
![Page 55: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/55.jpg)
SPC Chart Components
MeanMean
![Page 56: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/56.jpg)
SPC Chart Components
+1 SD +1 SD
-1 SD-1 SD
![Page 57: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/57.jpg)
SPC Chart Components
+2 SD +2 SD
-2 SD-2 SD
![Page 58: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/58.jpg)
SPC Chart Components
+3 SD +3 SD
-3 SD-3 SD
Upper Control Limit (UCL)
Lower Control Limit (LCL)
![Page 59: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/59.jpg)
Types of SPC Charts
Choosing the correct chart can be difficult - it is also very important.
Control limits are calculated differently for each chart.
...although they are marked in standard deviations, the formulas vary...
![Page 60: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/60.jpg)
Types of SPC Charts
![Page 61: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/61.jpg)
Choosing a Chart
• SPC charts– Use
• Same as Run Charts, except• Identify different types of variation
![Page 62: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/62.jpg)
Variation
Common Cause - ‘ In Control’Common Cause - ‘ In Control’
Special Cause - ‘Out of
Control’
Special Cause - ‘Out of
Control’
![Page 63: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/63.jpg)
Rules to Detect Special-Cause Variation
• one point above or below 3SD
• two of three points above/below 2SD
• four of five points above/below 1SD
• eight points in a row on either side of the mean
• trends of 6 points in a row increasing or decreasing
• fifteen points in a row within 1SD
• fourteen points in a row alternating up and down
• eight points in a row outside of 1SD
![Page 64: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/64.jpg)
Variation
Common Cause - ‘ In Control’Common Cause - ‘ In Control’
Special Cause - ‘Out of
Control’
Special Cause - ‘Out of
Control’
![Page 65: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/65.jpg)
A Special SPC Chart
• Often it is useful to provide reports that identify the ‘time since the last event’.
• This motivates and provides some competition
![Page 66: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/66.jpg)
A Special SPC Chart
• Rare events make terrible charts.
• Rates for rare events do not show you much.
![Page 67: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/67.jpg)
A Special SPC Chart
• You can combine the benefits of the ‘time between events’ and the issues with rare events into an SPC g Chart.
![Page 68: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/68.jpg)
C chart (number of events)
g chart (time between events)
![Page 69: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/69.jpg)
Choosing a Chart
• Most common/useful types of charts
4. Radar (Spider)
![Page 70: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/70.jpg)
Choosing Charts
• Radar– Rarely appropriate – confusing– May work for showing multiple percentages
in one small chart – Bar chart may still be better.
![Page 71: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/71.jpg)
Radar Charts
![Page 72: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/72.jpg)
Overview
• What makes a good report?• How to choose a chart• Components of good charts• Tips for reports• Standardized Infection Ratios
![Page 73: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/73.jpg)
Components of Good Charts
• Good charts tell the complete picture of what they contain
![Page 74: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/74.jpg)
Components of Good Charts
• Good charts tell the complete picture of what they contain
• Ideally, someone who is not familiar with the data being presented should be able to easily and quickly understand what the chart is representing
![Page 75: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/75.jpg)
Components of Good Charts
• Never use 3D charts unless you have a 3rd dimension
![Page 76: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/76.jpg)
Components of Good Charts
• The scale used for charts (that have a scale) should begin at zero and end near the highest value– Changing the axis scale can tell a drastically
different story to those that are just glancing
![Page 77: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/77.jpg)
Same Data, Different Scale
Anesthesia Medicine0%
5%
10%
15%
20%
25%
What would you say about these two services?
MRSA colonization rate by service
![Page 78: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/78.jpg)
Same Data, Different Scale
Anesthesia Medicine0%
5%
10%
15%
20%
25%
Anesthesia Medicine14%
15%
16%
17%
18%
19%
20%
21%
MRSA colonization rate by service
MRSA colonization rate by service
How about now?
![Page 79: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/79.jpg)
Overview
• What makes a good report?• How to choose a chart• Components of good charts• Tips for reports• Standardized Infection Ratios
![Page 80: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/80.jpg)
Tips for Reports
• Title must be very specific– Include person (organism/disease
state/compliance measure, etc.), place and time
• Example:– Hospital-associated Methicillin-resistant
Staphylococcus aureus Isolates: Hospital X, Acute Care ICU, January 2007-January 2010
![Page 81: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/81.jpg)
Tips for Reports
• Data definitions should be included as a footnote or on an introductory page.
![Page 82: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/82.jpg)
Tips for Reports
• Data definitions should be included as a footnote or on an introductory page.
• Example: Clostridium difficile– Definition for numerator
• Are you measuring toxin only? Antigen? By PCR? On liquid stool only?
– Definition for denominator• Patient-days? Admissions?
![Page 83: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/83.jpg)
Example introductory slide for MRSA rates
Hospital-associated Methicillin-resistant Staphylococcus aureus
(MRSA)
Case of MRSA (Numerator): A case of MRSA was defined as a new and unique, hospital-associated (isolated >48 hours after admission), microbiological isolate from a patient admitted to hospital x during the month of interest without a prior history of MRSA.
Patient days (Denominator): The denominator for the calculation of the rate of MRSA was defined as the number of patient-days for hospital x during the month of interest, regardless of risk status.
Rate: (Numerator / Denominator) * 1,000
![Page 84: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/84.jpg)
Tips for Reports• For charts, you should also include a
formula for how the rate was calculated.
![Page 85: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/85.jpg)
Tips for Reports• For charts, you should also include a
formula for how the rate was calculated.– # Unique, hospital-associated MRSA
isolates divided by # Patient-days of care X 1,000
![Page 86: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/86.jpg)
Tips for Reports• For charts, you should also include a
formula for how the rate was calculated.– # Unique, hospital-associated MRSA
isolates divided by # Patient-days of care X 1,000
– Be specific. Isolates, Infections, Colonizations, etc.
![Page 87: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/87.jpg)
Tips For Reports
• Include the appropriate chart!
![Page 88: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/88.jpg)
Tips for Reports
• Raw data is important to be able to understand what is in the chart and to verify the data.
![Page 89: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/89.jpg)
Tips for Reports
• Raw data is important to be able to understand what is in the chart and to verify the data.
• Some people just like the numbers.
![Page 90: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/90.jpg)
Tips for Reports
• Raw data is important to be able to understand what is in the chart and to verify the data.
• Some people just like the numbers.• Raw data should include numerator,
denominator and standardized rate.
![Page 91: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/91.jpg)
Tips for Reports
• Raw data is important to be able to understand what is in the chart and to verify the data.
• Some people just like the numbers.• Raw data should include numerator,
denominator and standardized rate.
![Page 92: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/92.jpg)
Tips for Reports
• Including aggregated data for quick comparisons is also a good idea.
• Yearly average rates may work.• When possible, include P-values to detect
statistically significant differences (rate comparison example to come..)
![Page 93: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/93.jpg)
Tips for Reports
• Always include a description of the assessment of the chart and your plans.
![Page 94: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/94.jpg)
Tips for Reports
• Always include bubbles or call-out boxes that adequately describe dates and components of any interventions.
![Page 95: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/95.jpg)
Tips for Reports
• You may use a bubble to describe if your surveillance definition changes.
![Page 96: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/96.jpg)
Tips for Reports
• You may use a bubble to describe if your surveillance definition changes.
• A better idea is to just start over.
![Page 97: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/97.jpg)
Hospital-Associated Methicillin-resistant Staphylococcus aureus Isolates: Hospital X, MICU, January 2006 – January 2010
# HA MRSA Isolates divided by # Bed-days of Care
Date
Number of Isolates
Number of Bed-Days of Care
Rate Per 1000 Bed-days of Care
Assessment: Process is in statistical control.
Plan: Continue surveillance activities.
![Page 98: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/98.jpg)
Tips for Reports
• Some reports must be text, although every attempt to transform into a graphic should be made.
![Page 99: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/99.jpg)
Tips for Reports
• Some reports must be text, although every attempt to transform into a graphic should be made.
• Keep text to a minimum with summary information presented.
![Page 100: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/100.jpg)
Tips for Reports
• Some reports must be text, although every attempt to transform into a graphic should be made.
• Keep text to a minimum with summary information presented.
• Email out early and often.
![Page 101: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/101.jpg)
Tips for Reports
• Another option is a dashboard. • This may be particularly useful for
providing back to staff to post in their work areas.
• After all – a report that isn’t used for something other than looking pretty is not particularly worth your time!
![Page 102: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/102.jpg)
Tips for Reports
![Page 103: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/103.jpg)
Tips for Reports
• KHA has a wonderful template for you!
![Page 104: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/104.jpg)
Overview
• What makes a good report?• How to choose a chart• Components of good charts• Tips for reports• Standardized Infection Ratios
![Page 105: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/105.jpg)
Standardized Infection Ratio
• SIR• A way to standardize/risk adjust rates for
better comparability across institutions
![Page 106: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/106.jpg)
Standardized Infection Ratio
• SIR• Why are rates not comparable?
– Different types of institutions have different patient populations
– These patients have different risks. – Therefore, comparing a University Hospital
MICU to a 4 bed Cardiac Unit in Wyoming is not useful.
![Page 107: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/107.jpg)
Standardized Infection Ratio
• SIR• SIR takes into account the types of
patients seen in various different types of units or wards in a healthcare facility.
![Page 108: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/108.jpg)
Standardized Infection Ratio
• SIR• Compares the number of infections you
have to the number you expect to see, based on some benchmark rate.
![Page 109: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/109.jpg)
Standardized Infection Ratio
• SIR– SIR>1 : Worse than expected numbers– SIR <1 : Better than expected numbers– SIR = 1 : As expected
![Page 110: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/110.jpg)
Standardized Infection Ratio• Advantages
– Adjusts based on benchmarked rates
– Adjusts for various locations [ICU vs Ward] or types of surgeries, etc.
– Excellent for comparing low numbers [removes high variation]
– Greater precision for adjustment
• Disadvantages– Statistical bias = may not
make appropriate comparisons
– Utility beyond SSI is relatively unstudied
– Wide understanding is just not there.
ICHE April 2006, 27(4): 427-429. ICHE January 2005, 26(1):8-9.
![Page 111: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/111.jpg)
SIR for CLABSI
1. Get observed numerator as usual
![Page 112: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/112.jpg)
SIR for CLABSI
1. Get observed numerator as usual
2. Get number of patient-days (line-days, vent-days, etc) as usual
![Page 113: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/113.jpg)
SIR for CLABSI
1. Get observed numerator as usual
2. Get number of patient-days (line-days, vent-days, etc) as usual
3. Get NHSN benchmark rate from the relevant publication
![Page 114: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/114.jpg)
SIR for CLABSI
1. Get observed numerator as usual
2. Get number of patient-days (line-days, vent-days, etc) as usual
3. Get NHSN benchmark rate from the relevant publication
4. Multiply benchmark rate by the number of patient days (line days, ventilator-days, etc)= expected number of infections
![Page 115: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/115.jpg)
SIR for CLABSI
Divide your observed number by the expected number = SIR!
![Page 116: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/116.jpg)
SIR for CLABSI
Example1. Get observed number of CLABSIs as
usual: 5
![Page 117: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/117.jpg)
SIR for CLABSI
Example1. Get observed number of CLABSIs as
usual: 5
2. Get number of line-days as usual: 1,234
![Page 118: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/118.jpg)
SIR for CLABSI
Example3. Get NHSN benchmark rate from the
relevant publication
Can compare to different percentile
rates if that is your goal!
![Page 119: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/119.jpg)
SIR for CLABSI
Example1. Get observed number of CLABSIs as usual: 5
2. Get number of line-days as usual: 1,234
3. Get NHSN benchmark rate from the relevant publication: 1.9
4. Multiply benchmark rate by the number of line-days and divide by 1,000 = expected number of infections:
(1.9 *1,234) / 1,000 = 2.35
![Page 120: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/120.jpg)
SIR for CLABSI
ExampleDivide your observed number by the
expected number = SIR!:
Observed (5)/ Expected (2.35) = 2.13
![Page 121: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/121.jpg)
SIR for CLABSI
Example
SIR = 2.13
You are doing worse than expected given the benchmark.
![Page 122: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/122.jpg)
SIR for CLABSI
• This method calculated an SIR for one particular unit.
• You can calculate an overall SIR that adjusts for multiple types of units. This makes it more comparable to other institutions.
Lets see how this works…
![Page 123: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/123.jpg)
SIR for CLABSI
Example Using Free Software
http://innovationsforglobalhealth.com/ipstat/
![Page 124: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/124.jpg)
Standardized Infection Ratio and SPC
• SIRs can be plotted on an XmR chart and may be more sensitive to detect special causes (very much controversy here!)
![Page 125: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/125.jpg)
Final Thoughts
• Charts are good – use them whenever possible.
![Page 126: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/126.jpg)
Final Thoughts
• Charts are good – use them whenever possible.
• Knowing your audience is important – don’t assume they know what you know or are interested in what you are interested in.
![Page 127: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/127.jpg)
Final Thoughts
• Charts are good – use them whenever possible
• Knowing your audience is important – don’t assume they know what you know or are interested in what you are interested in.
• SIRs may be useful in some situations
![Page 128: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/128.jpg)
Final Thoughts
• Make sure everyone knows how to read your charts
POST YOUR REPORTS WHEREVER YOU CAN
![Page 129: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/129.jpg)
More time?
• Example of how to make a control chart using Excel.
• Calculating P-values to compare rates
• You can download this file at:http://innovationsforglobalhealth.com/files/Stat_Tests_v13.xls
![Page 130: Presenting Data & Standardized Infection Ratios Tim Wiemken PhD MPH CIC Assistant Professor of Medicine Assistant Director of Epidemiology and Biostatistics](https://reader030.vdocuments.us/reader030/viewer/2022033105/56649e555503460f94b4c96e/html5/thumbnails/130.jpg)
Questions?
Thanks!