Transforming healthcare decision-making: The benefits of shifting from RAG tools to SPC charts

In healthcare settings, data visualisation plays a crucial role in helping professionals make quick, well-informed decisions around patient care, as well as to drive wider performance improvements. Traditionally, healthcare settings and organisations have relied on RAG (Red, Amber, Green) tools to log, monitor, categorise and sort masses of complex data, but presenting data in this way doesn’t always give busy executives the clearest or fullest picture of what’s happening .

In this blog post, we look at the limitations of RAG in a healthcare context, and look at Statistical Process Control (SPC) charts as a more nuanced tool for visualising key data from across organisations. We’ll explore the benefits for healthcare organisations of transitioning from RAG to SPC charts in both primary and secondary care contexts, and highlight how this shift can enhance decision-making, performance and patient outcomes.

Understanding RAG

RAG tools are a simple and widely used method of visualising performance data. Originally a project management tool used for monitoring how on-track teams were with individual tasks, they use a traffic light system – Red, Amber and Green – to highlight key indicators and determine different levels of performance.

• Red signifies a warning or critical issue
• Amber signifies a caution or moderate issue
• Green signifies that there are no issues and everything is running smoothly.

RAG tools are popular because they bring a degree of simplicity and visual appeal to often complex data. The colour-coded system is one that is recognised around the world, ensuring the data can be understood by everyone in the often diverse teams that make up healthcare organisations.

However, while RAG tools are easy to understand and provide a quick, at-a-glance overview of performance, there are limitations to the way data is presented that can mean deeper issues may be masked or hidden, and decision-making negatively impacted .

The limitations of RAG tools in healthcare settings

Healthcare settings and NHS trusts are large, dynamic organisations that generate masses of data on a daily basis. When using a simple traffic light system to track performance, there will necessarily be a limit to the level of insight a RAG presentation can provide.

Some of the biggest limitations include:

• Lack of context. RAG tools give a quick-glance visual of areas where performance is good, bad or acceptable at any given time, but they don’t provide context and they don’t show trends over time. This means they fail to indicate if a performance issue is part of a larger pattern, or if it is an isolated incident related to a specific event, making intervention less targeted.
• Subjectivity. The thresholds for what constitutes Red, Amber or Green is subjective and indeed may vary between different departments or even teams within the same department. This inconsistency means charts can easily be misinterpreted, and performance issues may fly under the radar due to unreliable comparisons.
• Over-simplified classification. RAG charts classify complex data into discrete categories, which can oversimplify the situation. This approach can make it difficult for decision-makers to see the full picture, obscuring the nuances and trends that are essential for understanding performance dynamics.
• No indication of variation. In healthcare, data naturally fluctuates due to a range of factors such as patient influx, staffing levels or seasonal variations. RAG charts don’t differentiate between random and fleeting fluctuations and significant changes that could indicate a more serious, systemic problem that requires attention.
• Invisibility of trends. RAG tools offer a point-in-time visualisation of data and fail to illustrate trends over time. If performance is gradually deteriorating yet remains in the Amber zone, it will not be picked up or addressed until it becomes a serious issue, tips over into the Red zone and requires urgent intervention . The simplicity of data presentation makes it almost impossible to predict what systems or processes will do next, which means intervention is only ever reactionary rather than proactive.

Introducing SPC charts

Statistical Process Control, or SPC, charts are a type of chart used to monitor the performance of processes over time. SPC charts are widely used in manufacturing and other industries where processes are central to output quality, because they help managers quickly identify variations and ensure ongoing quality control. In healthcare settings and organisations, SPC charts can support ongoing process improvement and clinical outcomes by providing managers and frontline staff with a more detailed and accurate picture of performance over time.

The benefits of SPC charts in healthcare organisations

• Continuous monitoring. SPC charts provide continuous monitoring of processes, allowing healthcare professionals and managers to see trends and spot patterns over time. This helps in identifying not only when something has gone wrong, but also the causes and potential solutions, which ultimately supports more informed interventions and data-driven decision-making.
• Distinguishes between natural and non-random variations. SPC charts help managers understand variations that lie within the process, differentiating between those that are natural (common cause variations) and those that are non-random and due to specific, identifiable factors (special cause variations). This distinction is critical in healthcare organisations and settings, where understanding the root cause of issues can lead to more effective interventions and more successful patient outcomes.
• Objective data interpretation. SPC charts use specific statistical methods for setting control limits based on the actual performance data, which ensures there is an objective and consistent basis for evaluating performance. This also makes it easy to roll out and embed the use of SPC charts across the organisation, rather than rely on the siloed reporting style of RAG tools.
• Acts as an early warning system. Because SPC charts provide a visualisation of trends over time, managers are able to identify variations and trends early. This allows healthcare leaders and professionals to take proactive measures to address and remedy any issues before they escalate, thereby improving operational efficiency and overall patient care.
• Supports better decision-making. SPC charts support more informed, data-driven decision-making in healthcare settings by providing more detailed and more contextual information in a quick-glance format. This means healthcare professionals and managers can make decisions based on bona fide insights rather than simple visual cues that lack nuance or context , and provides the ability to anticipate the ‘voice of the process’ and predict how systems will behave over time.

Switching from RAG to SPC charts in your organisation

Transitioning from RAG to SPC charts can undoubtedly support better, quicker and more informed decision-making in any healthcare setting, helping managers deliver ongoing performance improvements across the board. As with any major change, the transition will be easier and the rollout more successful if you invest a bit more time and thought into laying the groundwork before switching to SPC charts.

With leadership having embraced the use of time-series data and SPC, a successful transition away from RAG will include:

• Training and education. Ensure all staff members know how to use SPC charts and understand the principles of statistical process control. This should include being able to recognise different types of variation, how and when to log contextual notes on data points, and how to interpret charts correctly.
• Selecting metrics. Identifying the key performance metrics that will benefit most from SPC monitoring will be the single biggest determinant of the success of SPC within your organisation or setting. Metrics to consider might include patient wait times, infection rates, readmission rates or treatment outcomes.
• Data collection methods. Key to the usefulness of SPC charts is the data they use, so ensure data is being collected consistently and accurately. Software like BCN’s powerful EasySPC tool can then be used to automatically analyse the data and create easy-to-use, intuitive SPC charts.
• Integrating with existing systems. Integrating SPC charts with existing data visualisation and reporting systems, such as Microsoft’s Power BI, creates a comprehensive performance management framework that can be used to drive improvements across the organisation.

An opportunity to improve healthcare

The shift from RAG to SPC charts represents a significant opportunity for healthcare organisations to enhance their decision-making and improve performance. By providing deeper insights, distinguishing between different types of variation and supporting objective interpretation of masses of complex data, SPC charts can drive more effective interventions and better patient outcomes.

As you consider implementing SPC charts in your healthcare setting, BCN is here to provide not only the technology and tools, but the training and ongoing support that will make the transition a success.

See how BCN used Microsoft Power BI to create 10 unique SPC charts for the ELFT and significantly improved the trusts data insights compared to the previous, static RAG indicators

Discover how EasySPC can help you revolutionise your organisation’s data visualisation and decision-making processes, providing you with the tools and insights you need to drive a more informed, efficient and patient-centred approach to healthcare.

Learn more about EasySPC and get started today.