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anyone
who has spent time using statistical process control has encountered
measurement error. This occurs when we apply a measurement system to a
single object and get different results. We measure voltage or pH
reading two or three times in rapid succession and get two or three
different numbers.Such variation occurs in health care measurements, too. Visit your
neighborhood pharmacy, and you are likely to find an instrument that
allows you to check your blood pressure on the spot. If you stand near
one of these machines for a while, you inevitably hear someone say, "It
says my blood pressure is high, but it varies so much that it doesn't
mean anything." Measurement variation in health care is even more
slippery than in manufacturing, where we at least know we are measuring
the same thing repeatedly. In health care, this isn't the case. We
know, for example, that blood pressure does change constantly.
The so-called white coat effect can cause a person's blood pressure to
rise simply because he or she is nervous about having a doctor or nurse
measure it.
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