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The Christie speeds up SPC charts to improve clinical processes

Cancer specialist NHS trust implements statistical process control chart creation tool in data visualisation software Tableau to improve processes and save money

The Christie NHS Foundation Trust in Manchester has implemented visualisation software on statistical process control (SPC) charts to improve clinical outcomes.

The Christie is Europe’s largest single-site cancer centre, treating more than 44,000 patients a year.

Working with IT services company Trustmarque, the hospital’s business intelligence team has developed a software tool called Scutari that can create SPC charts on “any data set within Tableau”, says Dan Tibble, head of business intelligence and software development at The Christie.

The hospital wanted to be able to create SPC charts in Tableau that would enable the trust’s staff to monitor change impact and iterative improvement projects daily.

Trustmarque’s software developers came up with an automated script in C# that interfaces with Tableau, performing the calculations required to produce the charts, which have long been used in manufacturing to improve processes.

Staff at The Christie say they can now generate colour-coded SPC charts in minutes, rather than the hours it took to create them manually.

SPC charts apply statistical methods to analyse data in order to study and monitor process capability and performance.

Tibble said the NHS is starting to use the charts to spot non-random variations which pinpoint processes that can be improved. One of the goals in a healthcare context is to maximise the efficiency of a patient’s stay, reducing the time he or she needs to occupy a hospital bed.

The Christie’s business intelligence team has developed a software tool to create SPC charts

Without the use of SPC charts, there is a tendency to “hit the panic button” if a figure does not look quite right, says Tibble. The analysis made possible by the charts puts data into a clearer, more accurate context.

The trust has been using Tableau since September 2014 after choosing it ahead of QlikView, Business Objects and “the other usual suspects”, says Tibble. “It won hands-down as our tool of choice,” he adds.

Tableau is popular partly because it can reduce the need to hire developers, unlike its rival Qlik, says Tibble.

Read more about SPC

There are hundreds of active users of Tableau at The Christie, including Tibble’s team and the statisticians in the clinical outcomes team. They have been using the Scutari tool to generate SPC charts since December 2015.

Using Scutari, staff have been able to monitor the clinical and financial impact of processes across the trust. These include monitoring patients’ lengths of stay, bed availability and discharge times.

The Christie is also about to launch a new pharmacy system, and will use SPC charts to monitor the cost of pharmacy dispensing.

Drug procurement

It is already using Scutari to support drug procurement – for chemotherapy, for example. This means it can predict more accurately when there is a change in process that could have financial implications.

“Scutari has been a fantastic companion to Tableau, providing our staff with easily accessible and immediate statistics so they can analyse specific trends against a baseline in as much detail as needed,” says Tibble.

“Healthcare involves more complex sets of data than you typically find in commercial environments. There is a greater need for sophisticated statistical analysis.”

Nathaniel Van Gulck, business intelligence solutions architect at Trustmarque, says: “SPC charts have been used for decades in the manufacturing industry to improve quality, reduce waste and costs. These same techniques are now entering the healthcare sector. However, adoption to date has been patchy and slow.

“Too often the tools used to create SPC charts are confined to an analyst’s desktop with no way to effectively share or refresh them with the hospital staff who need to know.”



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