VALUE
IMPROVEMENT
LEADERS
TOPIC #13
673 words + 2 activities | 1 hr, 24 min (3 to read, 21 to watch video, 1 hour to plot a run chart and histogram)
HISTOGRAMS AND RUN CHARTS
PRINCIPLE
Histograms and run charts are two of the best ways to display a continuous dataset.

TOOLS
•  Histograms (available in Excel or free online calculators)
• Run charts (Excel)

APPLICATION
1. Watch the "Histograms and Control Charts" video  (21:01)
2.  Pick any continuous dataset and plot a run chart and histogram of it.
Opening confession: I’m self-plagiarizing quite a bit with this post on the clarifying power of histograms and run charts.
The Flaw of Averages (And Other Descriptive Stats)

That’s the title of a fun book for the amateur statistician. I’ll summarize: 

If you asked somebody to explain what a mean represents, what would they say? “It’s the average.” If you asked them to explain what the mean means ; what it represents, what would they say? 

Some use mean as a demarcation between above average and below average, a boundary between two foggy zones of goodness and badness. Others equate the mean with “normal” followed immediately with an impulse to apply an arbitrary distance from normal to abnormal and equally arbitrary judgments. Both of these instincts pose risks.

Standard deviation has the same problem. People don’t know what it is or how to use it. Worse, no one will ever ask you to explain it. 

As you lead value improvement projects, the goal is to communicate your data-driven conclusions without talking over your audience’s head.
Enter the Bins and the Dots

The histogram takes some thought for those unfamiliar, but it’s well worth it. Histograms represent distributions – the shape of your data. Data are grouped into “bins,” small ranges within the overall range of the dataset. In the example below (upper graph) the bins are 3 minutes wide. 

Showing the dots (a run chart) is a fast-track to true understanding. A run chart is a plot of your data in the sequence they occurred and thus we say it shows the direction of your data. Pro tip: Don’t be fooled by a scatter diagram which looks similar to a run chart but doesn’t have sequence on its x-axis. 

Together these two bring much clarity to the discussion enabling you to build a narrative and eliminate reliance on misleading point estimates (means and standard deviation). 

These graphs represent wait times at a fictional patient service desk.
Drawing their attention to the histogram, I might say, “You can see on the histogram that 26.5% of the sample waited 3 minutes or less. 74.5% of the sample waited 21 minutes or less, meaning 25.5% waited longer than 21 minutes. There’s a long tail, pulling the mean to the right. What if our next step is focusing on root causes of waits greater than around 20 minutes or more?”

On the run chart I’d say, “Most of the data points are below 20 minutes, but when the data goes up, it seems to stay up in little groups of 3 to 5 patients. We should find out why this happens. It looks like it happens every 7-20 patients. Let’s schedule a gemba walk focused on this pattern.”

Notice I included the mean on both charts so I can say, “Look how poorly the mean represents the dataset as a whole.” 

Of course we can’t just ignore the mean. We need it to calculate financial impact and conduct two sample t-tests. But the deceptive duo of mean and standard deviation are put in plain perspective with the honest histogram and reliable run chart. They contain more information and communicate it with greater clarity.
ACTIVITIES - Try Building These Charts


1. Watch the  "Histograms and Control Charts" video  (21:01)   all about histograms and control charts which are similar to, but more sophisticated than, run charts. It includes a histogram building demo at a free website.

2. Find any continuous dataset. In Excel, you can build a histogram in under a minute with the Data Analysis Toolpak (PC only) or using the Frequency function (PC or Mac). You can build a run chart even faster. There are many tutorials on the web or you can ask your coach for help. 
LINKS

Quickly locate all course videos, slides, and previous emails here .
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Questions? Email:  kim.mahoney@hsc.utah.edu