WMAHSN programme findings on trust boards' understanding of quality and safety performance measures published in leading journal


Posted on 15 April 2016 (Permalink)

The findings of a WMAHSN-supported programme which seeks to understand control charts - a graphical method that can be used to display hospital safety and quality performance measures - and how they might aid hospital board members' decision-making have been published in an esteemed journal. 

Hospital board members are asked to consider large amounts of quality and safety data with a duty to act on signals of poor performance. However, in order to do so, it is necessary to distinguish signals from noise (chance). The article from the programme team investigated whether data in NHS acute trust board papers are presented in a way that helps board members consider the role of chance in their decisions.

Thirty English NHS trusts were selected at random and their board papers were examined. 1488 charts depicting quality and safety were sampled, identified and analysed. The results of the investigation, which have now been published in the British Medical Journal (BMJ) Quality and Safety, showed that only 88 (6%) of these charts depicted the role of chance, and only 17 of the 30 board papers included any charts at all depicting the role of chance.

Control charts differ from other display methods, such as tables and line charts, in that they distinguish between special cause and chance variation. This is valuable, because investigating data that lies within the play of chance consumes resources that could be better devoted to other quality improvement efforts. 

The study concluded that while control charts can help board members distinguish signals from noise, often boards are not using them. The understanding of the use of control charts in NHS trusts is now better, and recommendations can be formulated to support the increased use of control charts in NHS trusts across the West Midlands in order to improve the analysis of information and appropriate decision-making.