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Posted 11th November 2024
First developed more than 100 years ago to monitor manufacturing processes, Statistical Process Control (SPC) is today used to drive quality improvements and process efficiencies across industries. In healthcare settings, SPC is a relatively recent addition but has already become a key enabler of QI, helping teams to analyse operational processes, detect issues and improve patient care in real-time.
But there is still plenty of untapped potential, and SPC can deliver far more benefits to healthcare organisations.
In this blog post, we look at four healthcare settings where SPC is making a tangible difference to outcomes, and look at further opportunities for SPC to empower ongoing evidence-based improvements…
With government targets to hit and patient outcomes to deliver, most healthcare organisations are driven to continuously improve the quality and safety of the care they provide. In this environment, SPC has become an essential tool for monitoring processes and outcomes, empowering teams to identify variations and make better informed, data-based decisions.
At Cincinnati Children’s Hospital Medical Center (CCHMC) in Ohio, SPC has been an integral part of their ongoing quality improvement journey, helping managers and teams alike to make significant and sustainable improvements.
SPC is now well embedded and part of the culture at CCHMC, with teams and leaders asking to see SPC charts and tools in order to make sense of challenges as they arise. It has helped managers implement targeted interventions to drive improvements in quality and patient safety and is proving valuable for both the organisation and the patients it serves.
Vanderbilt University Medical Center (VUMC) in Nashville, Tennessee, is also enjoying success in QI since introducing SPC, particularly when it comes to infection control and care quality. While they are still in the early days of SPC, the organisation is already seeing the benefits of enhanced charts and deeper insights to highlight consistent trends over time and differentiate them from isolated incidents.
As well as supporting improvements in patient safety, SPC is increasingly seen by healthcare organisations as vital for optimising patient flow across systems, emergency departments (EDs) and other areas where timely intervention is critical. Both VUMC and Nationwide Children’s Hospital (NCH) in Columbus, Ohio, leverage SPC to support learning in a way that empowers teams to improve access to patient care across facilities. The enhanced visibility into operational metrics that SPC provides allows these healthcare providers to make data-driven decisions to improve patient throughput and experience.
Another area where SPC can support better insights-based decision-making is in strategic planning. Hull University Teaching Hospitals NHS Trust (HUTH) leverages SPC as part of their strategic planning and performance evaluation activities and has embedded SPC within their Integrated Performance Report (IPR) to provide executives with insights and, where possible, assurance into hospital performance. With SPC charts integrated into their scorecards, they monitor approximately 180 key metrics across different care domains, helping leaders visualise trends, align operations with targets, and evaluate organisational performance against pre-set trajectories.
In a similar vein, both CCHMC and NCH are integrating SPC into executive and board reports, providing additional information and insights to leaders to help them make effective decisions about and across the organisation. Increasingly, executives and leaders at these organisations expect SPC to be used in reporting.
Across the teams at these organisations, SPC is being embedded into reporting and decision-making and is proving useful in supporting data-driven cultures. And as SPC becomes more intrinsic to decision-making, it is helping to provide and promote a common language to enable team members to communicate insights more effectively. Consequently, as well as improvement teams using SPC to demonstrate the impact of interventions, business intelligence teams are using it not only to report, but to support planning teams in delivering effective care.
All the hospitals we’ve looked at have embedded SPC into their organisational reporting and decision-making processes and have seen the benefits of doing so.
For example, HUTH’s use of SPC enables data to be analysed at specialty and care group levels, allowing managers to see where issues may be concentrated within the organisation. Their incorporation of a ‘spotlight’ feature means users can quickly identify where special causes or patterns of concern are present, so they can focus their attention on processes and matters that require immediate action. Further, their use of control charts across BI reports standardises data interpretation for clinical and operational teams, fostering a shared understanding of performance metrics whether at the board level or among clinical staff. This clarity facilitates better communication among and between teams, aligning them toward shared quality goals.
Despite the insights SPC delivers for healthcare organisations, there are plenty of areas where it can drive greater improvement and unlock further operational enhancements.
One of the biggest barriers to effective SPC implementation in healthcare is the knowledge gap among staff, especially those without a background in data analysis. SPC comes with its own set of statistical terms and concepts, which can be unfamiliar and even intimidating, particularly for non-technical users who are accustomed to more traditional data presentations.
To bridge this gap, many organisations like HUTH have introduced dedicated SPC training for both clinical and non-clinical staff. These programmes help staff interpret control charts and other SPC visuals, equipping them to make sense of process variations and understand which metrics indicate normal versus potentially problematic trends.
Investing in SPC training is not only essential for improving interpretation, it represents an opportunity to create a more data-driven culture. But organisations need to be realistic about the time it takes for this knowledge to become embedded. Practical, hands-on support during the early stages of adoption – through things like workshops or consultative coaching – can ensure staff feel confident and become invested in the success of SPC.
Though SPC offers nuanced insights, in the fast-paced world of frontline healthcare delivery, there will always be a demand for simpler indicators like red-amber-green (RAG) ratings. A large number of SPC indicators risks overwhelming decision-makers, and this can negatively impact patient care. HUTH found that executives sometimes prefer more straightforward indicators for assessing whether or not targets are being met. So while SPC provides deeper insights into the ‘why’ or the ‘how,’ enhancing these with quick, clear, easy-to-interpret markers could strike an effective balance between statistical rigor and intuitive decision-making support for executives. There is an opportunity here to combine SPC with simpler tools.
Manually inputting data is time-consuming, and this is generally one area where modern technology can help transform business operations. At HUTH, however, manually inputting data parameters such as targets and indicators into new SPC tools has been a challenge that has taken time.
Being able to automate this data integration would reduce the time and resources needed for manual configuration, as well as ensuring consistency across metrics.
Although the creation of SPC charts has historically been a manual process, by using automation within tools like Power BI and integrating them with electronic patient records, there is an opportunity to drastically reduce the time taken to create charts, thereby freeing up time and talent for analysis and decision-making.
Successfully embedding SPC into healthcare settings requires much more than just training; it needs a culture shift towards data-driven decision-making across the organisation. But fostering this engagement can take time and often requires strategic communication and long-term support.
In many cases, the key to initial engagement is in demonstrating SPC’s value through ‘quick wins’ in quality improvement and patient outcomes. For example, teams using SPC in infection control or patient flow improvements can prove small but impactful wins – such as reduced wait times or lower infection rates – that make a clear case for the benefits of SPC. Highlighting these successes with regular all-team briefings and cross-organisation communications can help win buy-in from frontline staff and leadership alike, encouraging them to make SPC a routine part of their processes.
To maintain momentum, organisations like Cincinnati Children’s have integrated SPC directly into their regular reporting frameworks, making it an expected part of weekly or monthly reviews. By embedding SPC into everyday workflows and aligning it with organisational goals, teams are more likely to see the value of SPC and actively engage with its use.
Statistical Process Control continues to support healthcare organisations in their approach to quality improvement. We are seeing SPC being used more broadly, too, with adopters more often aiming for organisation-wide use. And while SPC remains first and foremost a tool that supports QI initiatives, it is also delivering value in areas such as infection control, patient flow and executive reporting.
There is, however, substantial potential that remains untapped. Increasing training, automating data processes, and focusing on organisation-wide engagement will all enable SPC to be leveraged to its full potential in healthcare.
The experiences at NCH, VUMC, CCHMC and HUTH demonstrate that SPC, when used effectively, can drive meaningful improvements in patient outcomes and operational efficiency. Hospitals that embrace SPC will be better equipped to navigate the complexities of modern healthcare, using data not only to respond to challenges but to anticipate and prevent them. As the healthcare sector continues its journey toward data-driven improvement, SPC stands poised to play a central role in creating a safer, more efficient, more patient-centred future.
