Remig Wrazen 💙

NHS Anaesthetist, Adopted Brit/EUcitizen, MBA Medical Leadership, Self-Determination Theory of Motivation

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP This may seem like semantics, but it is actually really important for any QI work

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP Often, an improved process has significant variation for a while before it settles and is well embedded.

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP Somewhere between week 20 and 40 something has changed and the whole chart has shifted.

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP I am sorry but you don’t understand that either. These two charts represent two different processes. It is not the same proces but with reduced variation.

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP The more common scenario is when target falls within control limits of the stable process and managers overreact when one data point drops below the target

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP I am finding it difficult to believe that despite not reaching the arbitrary target, managers will be accepting the chart as “ought-to-be”

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP Do you think that reducing variation of the process in example A would make a difference?

[Remig Wrazen 💙 @rwrazen]

@alistairsteel @kurtstat @RCEMPolicyVP @MarkGraban He uses a name "Process Bevahiour Charts" to emphasise that is reflects how the process behaves

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP This is very unusual. Many control charts with a mean so close to the scale's edge are asymmetrical because one of the control limits is beyond the scale. If you move chart A to align its mean with the target, you will see what I mean

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP Specification limits are something you arbitrarily set. It is very different from control limits derived from process data.

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP I feel like you are mixing the control charts with 6 sigma process and its specification limits. In real life it is very unlikely that your process would look like B and would likely cause the same overreaction like A. Would rather educate execs than use tricks like that

[Remig Wrazen 💙 @rwrazen]

@kurtstat @alistairsteel @RCEMPolicyVP Not sure it works that way. You can envisage a process that sits within specification limits but fails do deliver on the target

[Remig Wrazen 💙 @rwrazen]

@sib313 @Melissa_S_Ryan This is the end of post Covid slump. Activity has grown through 24/25

[Remig Wrazen 💙 @rwrazen]

@sib313 @Melissa_S_Ryan The points are that the whole system expanded, doctors not the biggest part of that expansion, quantity is not quality

[Remig Wrazen 💙 @rwrazen]

@sib313 @Melissa_S_Ryan For someone who is usually sensible about statistics, this is as oversimplified as it gets. There is 35% more NHS staff than it was 10 years ago. The activity has gone up a lot. Among doctors the fastest growing group is LED IMGs with locally trained DRs facing unemployment

[Remig Wrazen 💙 @rwrazen]

@wesstreeting Paying doctors and other NHS staff well is the cost of providing high-quality care. Go and have an honest "what the NHS can afford" conversation with your voters.

[Remig Wrazen 💙 @rwrazen]

@WZ_Medicine @JakubStyczynski @mmzawisza Czyli że publiczna jest tak zła, że mając wybór nikt by nie chciał tam pracować?

[Remig Wrazen 💙 @rwrazen]

@sib313 Quality not quantity

[Remig Wrazen 💙 @rwrazen]

@LubimyczytacPL "Drive" Daniel H. Pink