Evidence map›Paper›PMID 39237263›Full record

Trial reportBMJ quality & safety2025

Cluster randomised evaluation of a training intervention to increase the use of statistical process control charts for hospitals in England: making data count.

Kelly Ann Schmidtke, Laura Kudrna, Laura Quinn, Paul Bird, Karla Hemming, Zoe Venable, Richard Lilford

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ quality & safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04977414 (A Randomized Controlled Evaluation a Training Intervention to Increase the Use of Statistical Process Control Charts for National Health Service Hospitals in England), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04977414 nacompletednot on this map

A Randomized Controlled Evaluation a Training Intervention to Increase the Use of Statistical Process Control Charts for National Health Service Hospitals in England

TypeinterventionalSponsorUniversity of WarwickRan2021 to 2023Enrolled15ConditionsStatistical Process Control ChartsArmsMaking Data Count Training intervention
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kelly Ann SchmidtkeLiberal Arts and Basic Sciences, University of Health Sciences and Pharmacy in St Louis, Saint Louis, Missouri, USA Kelly.Schmidtke@uhsp.edu.ORCID http://orcid.org/0000-0001-5993-0358
Laura KudrnaUniversity of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0002-8163-7112
Laura QuinnUniversity of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0001-9660-4631
Paul BirdInstitute of Applied Health, University of Birmingham, Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham Health Partners, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Karla HemmingSchool of Health and Population Sciences, University of Birmingham, Birmingham, UK.
Zoe VenableLiberal Arts and Basic Sciences, University of Health Sciences and Pharmacy in St Louis, Saint Louis, Missouri, USA.
Richard LilfordInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0002-0634-984X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe way that data are presented can influence quality and safety initiatives. Time-series charts highlight changes but do not clarify whether data lie outside expected variation. Statistical process control (SPC) charts make this distinction and have been demonstrated to be effective in supporting hospital initiatives. To improve the uptake of the SPC methodology by hospitals in England, a training intervention was created. The current study evaluates the effectiveness of that training against the background of a wider national initiative to encourage the adoption of SPC charts.

methodsA parallel cluster randomised trial was conducted with 16 English NHS hospitals. Half were randomised to the training intervention and half to the control. The primary analysis compares the difference in use of SPC charts within hospital board papers in a postrandomisation period (adjusting for baseline use). Trainees completed feedback forms with Likert scale and open-ended items.

resultsFifteen hospitals participated across the study arms. SPC chart use increased in both intervention and control hospitals between the baseline and postrandomisation period (29 and 30 percentage points, respectively). There was no statistically significant difference between the intervention and control hospitals in use of SPC charts in the postrandomisation period (average absolute difference 9% (95% CI -34% to 52%). In the feedback forms, 93.9% (n=31/33) of trainees affirmed learning and 97.0% (n=32/33) had formed an intention to change their behaviour.

conclusionsControl chart use increased in both intervention and control hospitals. This is consistent with a rising tide and/or contamination effect, such that the culture of control chart use is spreading across hospitals in England. Further research is needed to support hospitals implementing SPC training initiatives and to link SPC implementation to quality and safety outcomes. Such research could support future quality and safety initiatives nationally and internationally. TRIAL REGISTRATION NUMBER: NCT04977414.

Indexed as

HospitalsInservice TrainingCluster AnalysisEnglandHumansQuality ImprovementState Medicinecontinuous quality improvementdecision makinghealthcare quality improvementimplementation science

Identifiers

PMID39237263
PMCPMC12418577

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.