A Pareto chart is a graphical representation of the Pareto principle, which states that roughly 80% of effects come from 20% of causes. A Pareto chart is a bar graph that displays the relative frequency or size of problems in descending order of importance or frequency, with the most significant issue on the left and the least significant on the right.

The chart is named after Vilfredo Pareto, an Italian economist who observed that 80% of the land in Italy was owned by 20% of the population. This principle has since been applied to many fields, including quality control, where it is used to identify the most common sources of defects or problems.

To create a Pareto chart, the first step is to identify the problem or issues that need to be addressed. Next, data is collected on the frequency or size of each issue, and the issues are ranked in descending order based on their importance or frequency. Finally, the data is plotted on a bar graph, with the most significant issue on the left and the least significant on the right. A line graph is also added to show the cumulative percentage of issues, with the 80/20 point marked.

Pareto charts are commonly used in quality control, project management, and business process improvement. They are a useful tool for identifying the most significant issues that need to be addressed and prioritizing resources accordingly. By focusing on the most critical issues, Pareto charts can help organizations achieve significant improvements in efficiency, quality, and profitability.

Transparency is a driver of change in patient, provider, and institutional behaviors. It is an essential element of QI and patient safety, as well as building a culture of trust. Readmissions, infections, and same- or next-day appointments were influenced by the living Pareto chart; however, CSF leaks remained recalcitrant to data transparency. Other QI strategies may be necessary to positively affect the occurrence of CSF leaks in neurosurgery ¹⁾