Quality Improvement Tool: Pareto Chart

Introduction

A key tool in quality improvement and management.
Origin: Developed by Vilfredo Pareto, a sociologist and economist from Italy.
Based on the Pareto Principle, also known as the 80/20 rule.
- Discovered 80% of Italy's wealth was owned by 20% of the population.

Distinguishes the "vital few" from the "trivial many."
Applied to various fields for improving processes by focusing on significant issues.

Visual tool to analyze and represent frequency of defects or causes of a specific issue.
Consists of two Y-axes:
- Left Y-axis: Frequency of reasons.
- Right Y-axis: Cumulative percentage of the reasons.

Identify and list reasons
- For example, medication errors could include:
  - Wrong dose
  - Wrong time
  - Wrong patient
  - Dose repeated
  - Dose omitted
Collect and analyze data
- Review the data, e.g., 200 medication errors.
- Tally reasons for each error.
Rank reasons by frequency
- Create a bar chart with reasons in decreasing order of frequency.
  - E.g., Wrong dose (90), Wrong time (70), Repeated (20), Wrong patient (16), Omitted (4).
Calculate percentages
- Determine what percentage each reason is of the total errors.
  - E.g., 45% (wrong dose), 35% (wrong time), etc.
Calculate cumulative percentages
- Add percentages sequentially to find cumulative values.
Draw the cumulative percentage line
- Plot a line graph over the bar chart.
Identify the 80/20 split
- Locate where 80% cumulative percentage intersects with the line.
- Draw a vertical line to identify "vital few" (e.g., wrong dose, wrong time).

Pareto Charts are an essential tool for identifying and analyzing key issues in various processes.
Emphasizes addressing the most impactful problems first for effective quality improvement.