Pareto Chart: (Bar Graph in descending order of frequency)

Definition: The Pareto diagram/chart is a very powerful tool for showing the relative importance of problems (o
Information can be collected initially by: a) an audit; b) a survey using a questionnaire; c) developing a Driver Dia
number of votes when prioritising change ideas.
The highest frequency is the first bar in the Pareto Diagram and the next bar is the second highest frequency etc
A graph will automatically build as you enter your information into the table below.

Steps to follow:
Step 1: Download this spread sheet onto your computer via 'Save as'.
Step 2: Starting from the top (Cause / Problem 1) enter the name of your 'Causes / Problems' into the table belo
Step 3: Delete the rows you have not used (highlight row from left hand column and 'delete').
Step 4: Enter the frequencies (#) next to the appropriate causes
Step 5: Enter the Title of your graph: Click on the graph, click on the title, then enter the information you want d
Step 6: To print graph: Click on graph to highlight it, then click 'print' button.
Step 7: To copy graph to Power Point presentation: Click on graph to highlight it, right click and click 'Copy', ope
'Paste'.
Step 8: HOW TO INTERPRET YOUR PARETO CHART: The 'dots' from the red cumulative Frequency % line that fa
'causes' that you should focus on as a 'priority'. However, you can act on any of the 'causes' particularly if they m
Note: Only change values is the 'white' cells. The 'grey' cells will automatically calculate based on formulas within

Pareto Chart template with Cumulative line and 80% cut off
Do not alter this Do not alter this Do not alter this
column. It column. It column. It
calculates calculates calculates
automatically automatically automatically
10
Cumulative Cumulative 80% (80/20
Causes # 9

Frequency #
Total % rule)
Malfunction Accesssories 2 2 4% 80% 8
Leakage Component 1 3 5% 80%
7
Incomplete Material 3 6 11% 80%
Corrosion 4 10 18% 80% 6
Wrong Type 5 15 27% 80% 5
Geometry vs Spec 5 20 36% 80%
4
wiring Problem 8 28 51% 80%
Transport Defect 9 37 67% 80% 3
Mesurement 5 42 76% 80% 2
2
Wrong Execution 6 48 87% 80%
Finishing 1 29 53% 80% 1
Bad Storage 2 49 89% 80% 0
Painting 2 33 60% 80% Malfu
Acces
Defect Material 2 55 100% 80%

Total 55
Frequency #

16
14
12

Simple Pareto Chart template 10

8
6
4
2 1
0
s
r ie e
so on
ss
 16

Fre
14
12
10
8
6
Causes # 4
Malfunction Accesssories 1 2 1
Leakage Component 2 0
s
Incomplete Material ie
4 or ne
ss po
Corrosion 5 c es m
Ac Co
Wrong Type 6 n e
tio ag
nc ak
Geometry vs Spec 7 fu Le
al
wiring Problem 8 M
Transport Defect 9
Mesurement 10
Wrong Execution 11
Finishing 12
Bad Storage 13
Painting 14
Defect Material 15
Total 117
mportance of problems (or causes of a problem).
) developing a Driver Diagram and using Multi & Weighted Voting to tally up the

nd highest frequency etc...

blems' into the table below in DESCENDING order

e information you want displayed

click and click 'Copy', open power point file, select required slide, right click and
Frequency % line that fall UNDER the green "80% cut off" line relate to the
uses' particularly if they maybe easy to address or of high risk.
based on formulas within the cells.

% cut off

What patient doing when fell

10
9
9
Frequency #

8 80% line (80/20

8
7
6
6
5 5 5
5
4
4
3
3
2 2
2
1 1
1
0
Malfunction Leakage Incomplete Corrosion Wrong Type Geometry vs wiring Prob- Transport De- Mesurement Wrong Execu- Finishing Bad Storag
Accesssories Component Material Spec lem fect tion

Title:
Frequency #

Pareto Chart
Operational Definition: Data Collection Date/s: Sample Size:
16
14 12
12 11
10
10 9
8
8 7
6
6 5
4
4 2
2 1
0
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 16

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14 12
12 11
10
10 9
8
8 7
6
6 5
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 100%
Cumulative %

90%
80% line (80/20 Rule)
80%
70%
6
60%
5
50%
40%
30%
2 2 2
20%
1
10%
0%
ement Wrong Execu- Finishing Bad Storage Painting Defect Mate-
tion rial

Date/s: Sample Size:

15
14
13
12
11
10

l
t
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 15
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Exe Fi d Pa tM
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 #
Fr e que ncy
Pareto Chart examples Example data only Pareto Chart exam
100
9 2
90 8 3
80
70
60
50
40
30
20
10
0

Cumulative Cumulative 80% (80/20

Type of Medication error #
Total % rule)
Dose missed 92 92 21% 80%
Wrong time 83 175 41% 80%
Wrong drug 76 251 58% 80%
Over dose 59 310 72% 80%
Wrong patient 53 363 84% 80%
Wrong route 27 390 91% 80%
Wrong calculation 16 406 94% 80%
Duplicated drugs 9 415 97% 80%
Under dose 7 422 98% 80%
Wrong IV rate 4 426 99% 80%
Technique error 3 429 100% 80%
Unauthorised drug 1 430 100% 80%
Example data
Total 430 only

Number of incidents reported

Medication Safety
Incidents Example data
(all incidents in 6 months only
n=3797)
Type of Medication # of Cumulative Cumulative 80% (80/20
involved in incident incidents Total % rule)
Oxycodone 854 854 22% 80% 900 854
800
Morphine 723 1577 42% 80% 723
700
Fentanyl 587 2164 57% 80%
600
Insulin 293 2457 65% 80%
500
Paracetamol 233 2690 71% 80% 400
Other 211 2901 76% 80% 300
Hydromorphone 204 3105 82% 80% 200
Methadone 193 3298 87% 80% 100
Diazepam 182 3480 92% 80% 0
Enoxaparin 97 3577 94% 80%
Midazolam 79 3656 96% 80%
Heparin 59 3715 98% 80%
Warfarin 49 3764 99% 80%
Frusemide 33 3797 100% 80%
ncy

Total 3797
Fr eque

Cause s of Dischar ge De lay fr om Em e r ge ncy

Pa r e t o C har t
6 0 Audit of dischar ge de la ys in M a y & June
5 2
5 0

4 0

3 0

2 1
2 0
1 6

1 1
1 0

0
X-rays Be d sh o rt age on Re vi e w by te am Do c t o r
wa rd

Causes of discharge
delay from Emergency
Department (Audit in
Frequency
May & June)
X-rays 52
Bed shortage on ward 21
Review by team 16
Doctor busy 11
Patient complications 4
Other 3
Total 107
Example data
only

Where fall occurred on Where patient fall occurr

Number of falls
Aged Care Ward Frequency
(12 months retrospective data) Pareto
Operational definition: A fall is an even
Bed side 23 25 23
res
Chair 12 inadvertently on the ground
Toilet 6 20 12 month retrospective a
In room 4
Bathroom 2 15
12
Walking frame 2
Walking on ward 2 10
Nurses station 1 6
5 4
Transferring from Bed to c 1
lls

2 2
fa

Wheelchair 1
0
ti e nt

Total 54 Bed side Chair Toilet In room Bathroom Walking

frame
Example data
Pa

only Area where patient fall occur

of
N um be r

If the patient was moving 1 6

1 4
1 2
1 0
8
1 5
1 4
Ope r a

1 0
ti onal
ina
12
How
de finiti on:
dve r t e nt ly
m ont h
A
wa
fa
on
ll
s

r e t r ospe c
is
pa
a
t he
ti e nt
n
ti ve
Pa
gr ound
a
m ov
re t o
e ve nt
udit
w
C
or
of

when they fell, how were Frequency

6
4
4 3 3
2
0

they moving
Attempting to stand 15
Walking 14
Getting out of bed 10
Attempting to sit down 4
Bending/leaning/reaching over 3
Climbing over/around bedrails 3
Not known 2
Transferring from Chair to bed 2
Slid off bed pan 1
Slipped off chair 1
Total 55
Example data
only
What was the patients
activity at the time of Frequency What was the patients activit
the fall Pareto C

Number of Falls
12 Operational definition: A fall is an event wh
Attempting to stand 11 11 inadvertently on the ground or
Getting out of bed 6 12 month retrospective
Moving 6 10
Standing 6
Walking 6 8
Moving to go to toilet 5 6 6 6 6
Sitting 5 6
5 5 5
Toileting 5
Attempting to sit down 2 4
Climbing over/around bedrai 2
2 2 2
Sleeping in bed 2 2
Transferring from Chair to b 2
Bending/leaning/reaching 0
over 1
Changing pad 1
Picking up item off floor 1
Sleeping in chair 1
Other 1
Total 63
Example data
only

What was the patients

activity at the time of Frequency What was the Patients activity
the fall Pareto Ch
Number of falls

Operational definition: A fall is an event wh

Going to bathroom / Toileting 25 30 inadvertently on the ground or fl
Walking 11 12 month retrospective
25
Restless Sleep 9 25
Slipped when getting up 7
Changing pad 5 20
Going for a walk 4
Getting out of bed 3 15
11
Picking up item off floor 2 9
10
Sitting in chair 1 7
Sleeping in chair 1 5
5 4
3
Standing 1 2
Stood up and them fell 1 0
Going to Walking Restless Slipped Changing Going for Getting Pick
Total 70 bathroom Sleep when get- pad a walk out of bed up i
/ Toileting ting up off fl

Reasons why a risk

screen was not Reasons why a Risk Screen was not conducted on adm
conducted on admission Frequency (reasons stated by staff in Focus Group meetin
(reason stated by staff 9 Pareto Chart (n=33)
member) 8
8
Too busy 8 7
7
eMR fragmented / difficult 6
7 6
to use
No access to computer on
Number of votes

5
ward to complete risk 6
4
screen 4

1
 6
6

Number of votes
5
4
4
Screening too time consumi 4
3
Got interrupted and did not
4 2
complete falls screen
1
Thought it was not relevant 2
0
Thought it was not Too busy eMR fragmented / No access to Screening too Got inte
2 difficult to use computer on time consuming and d
mandatory to risk screen
ward to com- compl
Total 33 plete risk screen scr

Example data
only

Example only: A QI project team working to

improve immunization rates in the USA believed
that the cost of vaccination was the biggest Reasons stated by parent for lack of child immunization
barrier to improvement. After surveying the Pareto Chart
parents who were not up to date with their child's Survey of parents (n=368)
immunization, they found that cost was not an 200
issue, however transport to the clinic was the 185
biggest barrier. 180

160
Number

140
Reasons stated by parent 120
for lack of child Frequency
immunization 100
No Transport 185 80
No childcare 49
No information 35 60 49
See no need 33 40 35 33 29
Cost 29
No clinic 25 20
No time 12 0
Total 368 No Transport No childcare No information See no need Cost
Example data
only
Number of complaints

What patients
# complaints
complained about
Pain Management 73 Type of patient complaint
Respect 62 Pareto Chart
Communication / Information 21 80 (n=209)
73
Emotional Support 11 70 62
Care co-ordination 9 60
Noise on ward 8 50
Food 7 40
Cleanliness 7 30
6 21
Comfort
20
Discharge process 3 11 9 8 7 7
10
Family Involvement 2
0
Total 209
Example data
only
 10 7 7

Focus group - In relation to providing high

quality care for consumers, what were the
top issues you would consider important to
address? i.e. : When you come to work,

vot e s
what was the pebble (or pebbles) in your
shoe?

of
N um be r
Causes # of votes
M e nt al He a lt h St a ff Foc us Gr oup
40 Pa r e t o Cha r t
3 5 St a ff vot e s on t he t op / m ost im por t a nt issue s
35 t o pr ovide high qua lit y ca r e for M e nt a l He alt h
30
25 2 3 2 2
2 0 1 9
20 1 8 1 7 1 6
15 1 3
1 0 9
10 8

5
0

Leadership & Culture 35

Managing agitation & aggression 23
Compassionate care 22
Physical health 20
Prevention & early intervention
(de-escalation) 19
Staffing 18
Team work 17
Environment 16
Care Planning 13
Admission process 10
Boredom 9
Clinical Information sharing 8
Medication reconciliation 7
Policy 5
Clinical Review 3
Inter-ward transfer 1
Leave 1
Total 227
Example data
only

Incomplete documentation in Electronic Medical Record (

Audit in Acute Care Mental Health Unit (n=90)

30 28
Incomplete
documentation in eMR Count 25
Count

Audit in Acute Care Mental Health

Unit 21
20
20
Metabolic monitoring 28
Care plan 21 15
Admission checklist 20
Fall risk screen 6 10
Snr Medical Officer countersign 6
MDS 4
5 4 4
Correct GP 4
Strengths based language 4
0
No GP documented 3 Metabolic Care plan Admission Fall risk Snr Medical Correct
monitoring checklist screen Officer
Total 90 countersign
Example data MDS
only
 Tally of reason
Reasons for incomplete metabolic monitoring in Acute Care Ment
Reasons for incomplete Pareto Chart
metabolic monitoring in Tally of (n=135)
Acute Care Mental Health Reasons 35
30
Unit 30 27
Missing equipment 30 25
Staff forgot 27 20
20 18
Business of Unit 20
Agency staff unaware 18 15 12
10
Broken equipment 12 10
Unit staff unaware 10
5
Consumer acuity 10
Consumer refusal 6 0
Reason undetermined 2
Total 135
Example data
only

Barriers to antipsychotic Tally of Barriers to antipsychotic monitoring

monitoring Reasons Pareto Chart
40 (n=114)
Missing Equipment 35 35
35
Over reliance on GP 24
Limited referral information 20 30
Tally

24
Poor Communication 10 25
20
Clinical staff unaware 8 20
Missed appointments 8 15
Consumer refusals 7 10
10 8 8
Unclear cause 2
5
Total 114
Example data 0
t e s
only en GP o n o n
ar en
t
m n ati ati w
ip eo rm ni
c na nt
m
Eq
u nc nf
o u ff
u
oi
g lia li m ta p
i n r e ra om la s ap
i ss er fe
r C i c ed
M Ov re or in i ss
d Po Cl M
ite
m
Li
Number of c-sections

Indications for elective

caesarean section
#
Previous caesarean section 152
Malpresentation 87 Indications for Elective Caesarean Section
Major degree placenta previa 50 Pareto Chart
Hypertensive disorders 44 160 152 (n=506)
Foetal macrosomia 39 140
Risky obstetric history 33 120
Multiple pregnancy 25 100 87
Previous vesico-vaginal fistula 80
repair 21 60 50
44 39
Retroviral positive pregnancy 12 40 33
25 2
Severe intrauterine growth 20
restriction 8
0
Other 26
 60 50
44 39
40 33
25 2
20
0

Total 497
Example data
only

Fall Prevention Strategies NOT undertaken - Audit of 30 Medical Records

Fall Prevention
Strategies NOT # Fall Prevention Strategies NO
undertaken Pareto Chart
Multidisc. Rounds 30 (n=30)
Othostatic hypotension monitoring 27
Medications review 21 35
Risk Assessment 19
30
Falls Screening 12 30
27

Frequency
Delirium Screen 12
Cognition screen 7 25
Intentional Rounding 5 21
Environment management 1 20 19
Safe Mobilisation 1
Example data 15
only 12

10

0
Multidisc. Othostatic Medications Risk As- Falls Screen- D
Rounds hypotension review sessment ing
monitoring
 %
#

ti ve
Fr e que ncy

Cum ula
Pareto Chart example with Cumulative line
Types of Medi ca tion Errors
Pa ret o Cha rt Example data
100
12 mont hs of ret ros pective i nci dent da ta (n=430)
only
100%
9 2
90 8 3 90%
80 7 6 8 0 % line (8 0 / 2 0 Rule ) 80%
70 70%
5 9
60 5 3 60%
50 50%
40 40%
30 2 7 30%
20 1 6 20%
9 7
10 4 3 10%
1
0 0%
Number of incidents reported

Example data only

Medication Safety Incidents by Medication Name
Pareto Chart
All incidents reported in 6 months (n=3797)
Cumulative %

# of incidents Cumulative % 80% (80/20 rule)

900 854 100%
800 90%
723
80% line (80/20 Rule) 80%
700
587 70%
600
60%
500
50%
400
293 40%
300 233 30%
211 204 193 182
200 20%
97 79
100 59 49 33 10%
0 0%

Name of Medication

ha r ge De lay fr om Em e r ge ncy De par t m e nt

Pa r e t o C har t
ischa r ge de la ys in M a y & June (n=1 0 7 )
Example data
onl y

1 6

1 1

4 3

Re vi e w by te am Do c t o r busy Patie nt c o m p l i c a- Ot he r
tions
Where patient fall occurred on Aged Care Ward
Pareto Chart
finition: A fall is an event which results in a patient coming to
rest
ertently on the ground or floor or other lower level.
2 month retrospective audit of incident data (n

4
2 2 2
1 1 1

oom Bathroom Walking Walking on Nurses sta- Transferring Wheelchair

frame ward tion from Bed to
commode
Area where patient fall occurred

How wa s pa ti e nt m oving w he n t he y fe ll
E
Pa re t o Cha rt x
de finiti on: A fall is a n e ve nt w hich r e sult s in a pa ti e nt com ing
a t o r e st
nadve r t e nt ly on t he gr ound or floor or ot he r low e r le ve l.
m ont h r e t r ospe c ti ve audit of Age d Ca re Wa rd inc ide nt da m
p
l
e

d
4
3 3
a
2 2 t1 1
a

o
n
l
y
hat was the patients activity at the time of the fall
Pareto Chart
nition: A fall is an event which results in a patient coming to rest
vertently on the ground or floor or other lower level.
12 month retrospective audit of Aged Ca

5 5

2 2 2 2
1 1 1 1 1

at was the Patients activity at the time of their fall data only
Example
Pareto Chart
ition: A fall is an event which results in a patient coming to rest
ertently on the ground or floor or other lower level.
12 month retrospective audit of Aged C

5
4
3
2
1 1 1 1

hanging Going for Getting Picking Sitting in Sleeping Standing Stood up

pad a walk out of bed up item chair in chair and them
off floor fell

een was not conducted on admission E

y staff in Focus Group meeting) x
eto Chart (n=33)
a
m
p
l
e

4 4
d
a
t
a2 2

o
n
 l
e

4 4
d
a
t
a2 2

o
n
ss to Screening too Got interrupted l it was
Thought Thought it was
er on time consuming and did not not y
relevant not mandatory to
com- complete falls risk screen
screen screen

for lack of child immunization E

to Chart x
arents (n=368) a
m
p
l
e

d
a
t
a
o
n
l
y

33 29 25
12

n See no need Cost No clinic No time

Example data only

patient complaint
areto Chart
(n=209)

8 7 7 6
3 2
 7 7 6
3 2

nt al He a lt h St a ff Foc us Gr oup
Pa r e t o Cha r t
e t op / m ost im por t a nt issue s t o addr e ss
qua lit y ca r e for M e nt a l He alt h c onsum e r s Example data only

1 6
1 3
1 0 9 8 7
5
3
1 1

in Electronic Medical Record (eMR)

Mental Health Unit (n=90)

6
4 4 4
3

Fall risk Snr Medical Correct GP Strengths No GP doc-

screen Officer based umented
countersign language
MDS
monitoring in Acute Care Mental Health Unit
areto Chart Example data only
(n=135)

12
10 10
6
2

ntipsychotic monitoring
areto Chart
(n=114)

10
8 8 7
2

n e t s ls se
tio ar en sa au
ca w fu c
u na nt
m r e ar
ff oi er c le
ta p um Un
la s ap ns
i c ed Co
in i ss
Cl M

Elective Caesarean Section

Pareto Chart
(n=506)

39
33
25 21 26
12 8
 39
33
25 21 26
12 8

Prevention Strategies NOT undertaken

Pareto Chart
(n=30)

19

12 12

7
5

1 1

s Risk As- Falls Screen- Delirium Cognition Intentional Environment Safe Mobilisa-
sessment ing Screen screen Rounding management tion
 #
Fr e que ncy
Simple Pareto Chart example
Types of Medi ca tion Errors
Paret o Cha rt
12 mont hs of ret ros pective i nci dent da ta (n=430) Example data only
100
9 2
90 8 3
80 7 6

70
5 9
60 5 3
50
40
30 2 7

20 1 6
9 7
10 4 3 1
0
r e p or t e d
i nc i de nt s
of
be r
um
N

Me dicati on Safe t y Incide nt s by Me dicati on Name

Pa ret o Cha rt
All incide nt s r e por t e d in 6 m ont hs(n= 3797) E xa m pl e da t a onl y
9 0 0 8 5 4
8 0 0
7 2 3
7 0 0
5 8 7
6 0 0
5 0 0
4 0 0
2 9 3
3 0 0 2 3 3 2 1 1 2 0 4 1 9 3 1 8 2
2 0 0
9 7 7 9
1 0 0 5 9 4 9 3 3
0

Name of Me dicati on

Causes of discharge
delay from Emergency
Department
Bed shortage on ward
Doctor busy
Patient complications
Other
X-rays
Review by team
Total
ors
A
Types of Medication Errors
data (n=430) Example data only

P
Pie Chart i
16 7 94 3 1 e
4 3

92
1

27
c
h
53 a
r
t
i
s
n 83
o
59 76 t
r
e
c
o
Dose mi ssed Wrong time Wrong drug m
Over dose
Wrong patient Wrong route Wrong cal cul ation m
Dupl i cated drugs
e
Under dose Wrong IV rate Techni que error Unauthori
n sed drug
d
e
d
a
s
i
t
i
s
d
i
f
f
i
c
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r
p
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e
t
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a
t
e
d
t
o
a
P
a
r
e
t
o
C
h
a
r
t

E xa m pl e da t a onl y

7 9 5 9 4 9 3 3

Frequency
 21
11
4
3
52
16
107
83

ose
ated drugs
hori sed drug
Pareto Principle or 80/20 Rule

The Pareto Principle was developed by 20th century business scholar Joseph Juran, who named the rule afte
Juran described it as the rule of the “vital few and trivial many" since it's used to weed out less important fac
Further reading:
The Pareto principle (also known as the 80–20 rule, the law of the vital few, and the principle of factor sparsi
Management consultant Joseph M. Juran suggested the principle and named it after Italian economist Vilfred
Essentially, Pareto showed that approximately 80% of the land in Italy was owned by 20% of the population;
Pareto developed the principle by observing that 20% of the pea pods in his garden contained 80% of the pea
It is a common rule of thumb in business; e.g., "80% of your sales come from 20% of your clients."

HOW TO INTERPRET YOUR PARETO CHART: The 'dots' from the red cumulative Frequency % line that fall UNDER the green "80% cut
However, you can act on any of the 'causes' particularly if they maybe easy to address or of high risk.

Cumulative Cumulative Vital

Causes # 80% Cut off
Total % 16
15
Malfunction Accesssories 15 15 17% 80%

Frequency #
14
Leakage Component 14 29 32% 80%
Incomplete Material 12 41 46% 80% 12
Corrosion 10 51 57% 80%
10
Wrong Type 9 60 67% 80%
Geometry vs Spec 8 68 76% 80% 8
wiring Problem
2
7 75 83% 80%
0
Transport Defect 6 81 90% 80% %
6

Mesurement 5 86 96% 80%

4
Wrong Execution 4 90 100% 80% o
Finishing 3 78 87% 80% f 2

Bad Storage 3 67 74% 80% t 0

Painting 2 57 63% 80% h Malfunction
Accesssories
Defect Material 2 49 54% 80% e
Total 90 c
a
u
s
e
s

y56764
who named the rule after Italian economist Vilfredo Pareto.
ed out less important factors in decision making.

principle of factor sparsity) states that, for many events, roughly 80% of the effects come from 20% of the causes.
Italian economist Vilfredo Pareto, who, while at the University of Lausanne in 1896, published his first paper "Cours d'écon
y 20% of the population;
contained 80% of the peas

all UNDER the green "80% cut off" line relate to the 'causes' that you should focus on as a 'priority'.

Vital Few
16
15
Frequency #

14
14
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10
10
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8
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4
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d his first paper "Cours d'économie politique."

100%
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90%
80% Cut off (80/20 Rule)
80%
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70%

60%

50%

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5
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rement Wrong Execu- Finishing Bad Storage Painting Defect Mate-
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Also watch and learn from this You Tube clip: https://www.youtube.com/watch?v=dMWq48_TsNo