Statistical process control charts for monitoring military injuries. 2017

Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
Army Public Health Center, Aberdeen Proving Ground, Maryland, USA.

An essential aspect of an injury prevention process is surveillance, which quantifies and documents injury rates in populations of interest and enables monitoring of injury frequencies, rates and trends. To drive progress towards injury reduction goals, additional tools are needed. Statistical process control charts, a methodology that has not been previously applied to Army injury monitoring, capitalise on existing medical surveillance data to provide information to leadership about injury trends necessary for prevention planning and evaluation. Statistical process control Shewhart u-charts were created for 49 US Army installations using quarterly injury medical encounter rates, 2007-2015, for active duty soldiers obtained from the Defense Medical Surveillance System. Injuries were defined according to established military injury surveillance recommendations. Charts display control limits three standard deviations (SDs) above and below an installation-specific historical average rate determined using 28 data points, 2007-2013. Charts are available in Army strategic management dashboards. From 2007 to 2015, Army injury rates ranged from 1254 to 1494 unique injuries per 1000 person-years. Installation injury rates ranged from 610 to 2312 injuries per 1000 person-years. Control charts identified four installations with injury rates exceeding the upper control limits at least once during 2014-2015, rates at three installations exceeded the lower control limit at least once and 42 installations had rates that fluctuated around the historical mean. Control charts can be used to drive progress towards injury reduction goals by indicating statistically significant increases and decreases in injury rates. Future applications to military subpopulations, other health outcome metrics and chart enhancements are suggested.

UI MeSH Term Description Entries
D008889 Military Personnel Persons including soldiers involved with the armed forces. Air Force Personnel,Armed Forces Personnel,Army Personnel,Coast Guard,Marines,Navy Personnel,Sailors,Soldiers,Submariners,Military,Force Personnel, Air,Personnel, Air Force,Personnel, Armed Forces,Personnel, Army,Personnel, Military,Personnel, Navy,Sailor,Soldier,Submariner
D011159 Population Surveillance Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy. Surveillance, Population
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014947 Wounds and Injuries Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity. Injuries,Physical Trauma,Trauma,Injuries and Wounds,Injuries, Wounds,Research-Related Injuries,Wounds,Wounds and Injury,Wounds, Injury,Injury,Injury and Wounds,Injury, Research-Related,Physical Traumas,Research Related Injuries,Research-Related Injury,Trauma, Physical,Traumas,Wound
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates

Related Publications

Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
May 2007, BJOG : an international journal of obstetrics and gynaecology,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
April 1994, Infection control and hospital epidemiology,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
July 2011, Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
February 2007, The Journal of hospital infection,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
January 2019, Quality management in health care,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
January 2009, Revista de salud publica (Bogota, Colombia),
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
January 2021, Frontiers in oncology,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
February 2022, Water science and technology : a journal of the International Association on Water Pollution Research,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
July 2007, The Journal of hospital infection,
Anna Schuh, and Michelle Canham-Chervak, and Bruce H Jones
July 2015, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB),
Copied contents to your clipboard!