Please read the situation and answer the questions below.

1. Are patient falls to be considered attributes or variables data?

2. A c-chart was used to analyze the data. Is this type of chart appropriate? If it is not appropriate, what led you to this conclusion?

The Situation In September 1991, your hospital introduced a new program to re- duce the number of patient falls. As risk manager, you have been asked repeatedly, "Did this new program have the desired im- pact?" To determine the answer, you decide to take advantage of the knowledge and experience of the team that created the pro- gram. They have been working on this since January 1991 and 134 MEASURING QUALITY IMPROVEMENT IN HEALTHCARE have (1) developed and maintained a consistent operational defi- nition of a patient fall (i.e., "an unplanned and unexpected change in a patient's position, with the patient landing on the floor"), (2) developed and implemented an ongoing data collection plan, and (3) prepared two control charts (found in Figures 6.17 and 6.18). Figure 6.17 presents data for the 24 months from January 1, 1991, through December 31, 1992. During these months the census was relatively constant. Each data point represents the total num- ber of falls occurring within all 20 units each month. Since the new prevention program was implemented in September 1991, Figure 6.17 shows the number of falls both before and after the preven- tion program. Note that the mean and control limits in this figure are based on the 9 months from January to September 1991, not on all 24 data points. Figure 6.18, on the other hand, shows data only for the 15 months following the introduction of the falls preven- tion program. The Situation In September 1991, your hospital introduced a new program to re- duce the number of patient falls. As risk manager, you have been asked repeatedly, "Did this new program have the desired im- pact?" To determine the answer, you decide to take advantage of the knowledge and experience of the team that created the pro- gram. They have been working on this since January 1991 and 134 MEASURING QUALITY IMPROVEMENT IN HEALTHCARE have (1) developed and maintained a consistent operational defi- nition of a patient fall (i.e., "an unplanned and unexpected change in a patient's position, with the patient landing on the floor"), (2) developed and implemented an ongoing data collection plan, and (3) prepared two control charts (found in Figures 6.17 and 6.18). Figure 6.17 presents data for the 24 months from January 1, 1991, through December 31, 1992. During these months the census was relatively constant. Each data point represents the total num- ber of falls occurring within all 20 units each month. Since the new prevention program was implemented in September 1991, Figure 6.17 shows the number of falls both before and after the preven- tion program. Note that the mean and control limits in this figure are based on the 9 months from January to September 1991, not on all 24 data points. Figure 6.18, on the other hand, shows data only for the 15 months following the introduction of the falls preven- tion program