Monitoring rare events: a comparison of four SPC methods

• Research type

  Research Study

• Full title

  Monitoring rare events: a comparison of four statistical process control methods (p, g, XmR and CUSUM charts)

• IRAS ID

  165804

• Contact name

  Tim Draycott

• Contact email

  tdraycott@me.com

• Sponsor organisation

  North Bristol NHS Trust

• Duration of Study in the UK

  0 years, 7 months, 31 days

• Research summary

  Aims
  To compare four different ways to monitor rare adverse events in maternity care to determine which method
  • provides the earliest warning of possible care quality issues
  • is easy to interpret for clinicians, managers and lay people

  Background
  North Bristol NHS Trust (NBT) has developed a dashboard to alert clinicians to increases in adverse outcomes, which could indicate potential issues with care quality. Although well suited to most outcomes monitored, research suggests that the current method may not be optimal for monitoring rare events. However, comparative guidance on the best method is lacking. This study addresses this problem, which affects many healthcare areas dealing with rare events.

  Study design
  This study will compare four Statistical Process Control (SPC) monitoring methods to see which gives the earliest warning of potential care quality issues. SPC, which combines statistical precision with practical usability for non-statisticians, is a set of quality monitoring techniques originating in manufacturing but used increasingly in healthcare.

  Each monitoring method will be applied to the same dataset of babies born between 1-Jan-2001 and 31-Dec-2013 at NBT, to compare alerts for the proportion of full-term babies with an Apgar score of less than 7 at 5 minutes (a score to summarise the baby’s condition shortly after birth). The study will use existing, anonymised data, which have been collected routinely as part of women’s care.

  We will also show the different monitoring charts to doctors, midwives and maternity service users and check how easy they are to understand, based on a number of scenarios.

  Dissemination
  The study results will be applied to NBT’s maternity dashboard and will be shared with clinicians, managers, commissioners and maternity service users through regional Clinical Networks and the Maternity Services Liaison Committee. They will also be reported in a peer-reviewed healthcare quality journal.

• REC name

  North East - Tyne & Wear South Research Ethics Committee

• REC reference

  14/NE/1244

• Date of REC Opinion

  10 Dec 2014

• REC opinion

  Favourable Opinion