Quality improvement (QI), or improvement science, uses quantitative data to show change in a process. One example of using QI to demonstrate changes in processes of care is the Institute of Medicine’s quality and safety goals; the STEEEP (safety, timeliness, efficiency, effectiveness, equitability, and patient centeredness) framework can be used to determine priorities for assessing and measuring changes in clinical settings, with the goal of improving patient care and outcomes.1 

Many investigators focus on sample size when measuring improvement in outcomes across the STEEEP framework. However, the true measure of process improvement is process change and the sustainability of that change, versus a sample size of particular magnitude.2  The first objective in evaluating QI effectiveness is determining whether a change has occurred by using a data point series. The second objective is to determine the stability of the change by using data points obtained after the process...

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