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Measurement to understand our current performance and where we can improve is an essential component of ensuring that care is safe and effective for our patients. Most clinicians are familiar with audit, 1 and indeed, anaesthetists in the UK have used this technique very effectively, especially with the Royal College of Anaesthetists' National Audit Projects (NAPs) 2 3 and National Emergency Laparotomy Audit. 4 However, many of us have been taught very little about other ways to measure for improvement, such as the use of sampling, the use of run charts and statistical process control charts, the understanding of unwanted variation, and the requirements to interrogate and analyse large databases.

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