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Considering chance in quality and safety performance measures : an analysis of performance reports by boards in English NHS trusts
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Schmidtke, Kelly, Poots, Alan J., Carpio, Juan, Vlaev, Ivo, Kandala, Ngianga-Bakwin and Lilford, Richard (2017) Considering chance in quality and safety performance measures : an analysis of performance reports by boards in English NHS trusts. BMJ Quality & Safety, 26 . pp. 61-69. doi:10.1136/bmjqs-2015-004967 ISSN 2044-5415.
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Official URL: http://dx.doi.org/10.1136/bmjqs-2015-004967
Abstract
Objectives: 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). This article investigates whether data in English National Health Service (NHS) acute care hospital board papers are presented in a way that helps board members consider the role of chance in their decisions.
Methods: Thirty English NHS trusts were selected at random and their board papers retrieved. Charts depicting quality and safety were identified. Categorical discriminations were then performed to document the methods used to present quality and safety data in board papers, with particular attention given to whether and how the charts depicted the role of chance, that is, by including control lines or error bars. Results: Thirty board papers, containing a total of 1488 charts, were sampled. Only 88 (6%) of these charts depicted the role of chance, and only 17 of the 30 board papers included any charts depicting the role of chance. Of the 88 charts that attempted to represent the role of chance, 16 included error bars and 72 included control lines. Only 6 (8%) of the 72 control charts indicated where the control lines had been set (eg, 2 vs 3 SDs).
Conclusions: Hospital board members are expected to consider large amounts of information. Control charts can help board members distinguish signals from noise, but often boards are not using them. We discuss demand-side and supply-side barriers that could be overcome to increase use of control charts in Q1 healthcare.
| Item Type: | Journal Article | ||||||||||
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| Divisions: | Faculty of Social Sciences > Warwick Business School > Behavioural Science Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Social Sciences > Warwick Business School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | BMJ Quality & Safety | ||||||||||
| Publisher: | BMJ Publishing Group Ltd. | ||||||||||
| ISSN: | 2044-5415 | ||||||||||
| Official Date: | 1 January 2017 | ||||||||||
| Dates: |
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| Volume: | 26 | ||||||||||
| Page Range: | pp. 61-69 | ||||||||||
| DOI: | 10.1136/bmjqs-2015-004967 | ||||||||||
| Status: | Peer Reviewed | ||||||||||
| Publication Status: | Published |
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