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Evaluate Initiative to Improve the Use of Statistical Process Control (SPC) Charts

Leads: Ms Jodie Mazur (WM-AHSN), Dr Laura Kudrna, Dr Kelly-Ann Schmidtke, Dr Laura Quinn (Meths)

We are working with public contributors from ARC WM to share the output of this study.

Dates: January 2019 - March 2021


Hospital board members use data to inform their decision-making. The way that these data are presented can impact whether hospital board members choose to intervene. Research shows that the process limits on statistical process control (SPC) charts improve the ability of hospital decision-makers to align their investigative recommendations with statistical findings. Yet previous research from CLAHRC WM showed that SPCs are not widely used within the UK National Health Services (NHS). As a result, an educational training initiative called ‘Making Data Count’ was established by NHS Improvement/England (NHS-I/E) to improve uptake of SPC charts in NHS institutions.

Policy and Practice Partners:

West Midlands Academic Health Science Network.

Co-Funding Partners:

NHS England, West Midlands Academic Health Science Network.

Aims and Objectives:

The present research will evaluate the impact of NHS-I/E training sessions on SPC chart usage.


A controlled before and after design will be used. SPC chart usage will be examined in a sample of 40 board papers across 20 trusts. We will ascertain the proportion of charts which could be control charts and which are. The sample will include 20 board papers across ten trusts (sampled sequentially) that have completed the training intervention (ten pre and ten post intervention), and 20 board papers across ten different trusts that have not completed the training intervention that will be external controls. These control trusts will be selected on the basis of matching for size (bed number). Poisson regression will be used to compare rates of control chart usage pre and post intervention, and between the intervention and control groups, using a difference in difference approach. Qualitative thematic analysis of feedback forms will be conducted.

Main Results:

The present research will evaluate the impact of NHS-I/E training sessions on the use of SPC charts by examining whether or not SPC charts appear in NHS trust board papers before and after trainings. The results will contribute to our understanding of whether and why educational initiatives are effective in changing how data are used within healthcare settings.


Awaiting. The paper is an advanced stage of production and will be submitted in April 2021.

Implications for Implementation:

Board members will have access to data in a format that promotes good decision making. Having shown that the intervention promoted by ARC WM and NHS Improvement should now be extended to other NHS organisations.