Understanding Statistical Process Control (SPC)

Charts
Introduction
This guide is intended to provide an introduction to Statistic Process Control (SPC) charts. It can
be used with the ‘AQuA SPC tool’ to produce, understand and interpret your own data. For
guidance on using the tool see the ‘How to use the AQuA SPC Tool’ document.

This introduction to SPC will cover:

• Why SPC charts are useful

• Understanding variation
• The different types of SPC charts and when to use them
• How to interpret SPC charts and what action should be subsequently taken

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Why SPC charts are useful
When used to visualise data, SPC techniques can be used to understand variation in a process
and highlight areas that would benefit from further investigation.

SPC techniques indicate areas of the process that could merit further investigation. However, it
does not indicate that the process is right or wrong.

SPC can help:

• Recognise variation
• Evaluate and improve the underlying process
• Prove/disprove assumptions and (mis)conceptions
• Help drive improvement
• Use data to make predictions and help planning
• Reduce data overload

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Understanding variation
In any process or system you will see variation (for example differences in output, outcome or
quality)

Variation in a process can occur from many difference sources, such as:
• People - every person is different
• Materials - each piece of material/item/tool is unique
• Methods – doing things differently
• Measurement - samples from certain areas etc can bias results
• Environment - the effect of seasonality on admissions

There are two types of variation that we are interested in when interpreting SPC charts -
‘common cause’ and ‘special cause’ variation.

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Common cause
If the process is stable and predicable any variation is known as ‘common cause variation’. A
process is ‘in control’ if it only displays common cause variation.

Special cause
If the process is unstable or ‘out of control’ any variation is known as ‘special cause variation’. This
means that it is not an inherent part of the process. Special cause variation highlights that
something unusual has occurred within the process and is attributable to factors that were not
within the original process design.

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The different types of SPC charts and when to
use them
Statistical Process Control (SPC) charts are simple graphical tools that enable process
performance monitoring. They are used to identify which type of variation exists within the
process. They highlight areas that may require further investigation.

Two of the most popular SPC tools are the run chart and the control chart. Both can be produced
with the ‘AQuA SPC tool’ to analyse data that is observed over a period of time. These are called
‘dynamic processes’. Charts showing this type of data are often referred to as a ‘time-series’ or a
‘longitudinal’ SPC chart.

A process that is not observed over a period of time is called a ‘static processes’ A Funnel chart is
commonly used in these cases. These charts are useful for understanding variation for a process
at multiple organisations, such as hospitals or GP practices. This can be done using the ‘AQuA
Funnel Chart Tool’.

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The run chart
This shows data collected over a period of time. The time series plotted on the horizontal or x axis.
The centreline of a run chart consists of the median (the middle value when all values are ranged
in ascending order).
Median

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 UCL
Control chart
A control chart is similar to a run chart
but with the addition of control limits
(an Upper Control Limit (UCL) and a
Lower Control Limit (LCL)). The
centreline is calculated by the mean.

This chart enables the monitoring of

the process level and identification of
the type of variation in the process
over time with additional rules
associated with the control limits.
Mean LCL
To produce a control chart you need an absolute minimum of 10 data points to create a valid
chart, however there is increased reliability when using 20 or more data points. If one of the
initial data points is out of process limits you may like to consider excluding that point from the
calculations.
Ideally, control limits will remain fixed unless you have made a process improvement – i.e. you
made a fundamental change to the process and it improved the process (this would be evident
through ‘special cause’ variation). Following this, you may wish to recalculate the control limits.
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Interpreting charts to identify special cause
variation
If you can see any of the following it means that there is special cause variation. The first four
rules can be applied to both run charts and control charts:

1. Shift - seven or more successive data points falling on the same side of the centreline
2. Trend - seven or more successive data points heading in the same direction (either increasing
or decreasing)
3. Zig-Zag - fourteen or more successive data points decrease and increase alternatively
(creating a zig-zag pattern)
4. Cyclical Pattern - a regular pattern occurring over time – for example a seasonality effect
There are additional rules for control charts:
6. Control limits - one or more data points fall outside the control limits
7. Middle third - the number of points within the middle third of the region between the
control limits differs markedly from two-thirds of the total number of points
The following pages illustrate these rules.
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 Identifying special cause variation - shift

7 points
UCL above
centreline
X
X X
X
X X X
X X X
Centreline X
X X X
X X X
X
X
X X
X
LCL 7 points
below
centreline

This rule applies to run charts and control charts 10

 Identifying special cause variation - trend
7 points in
an
UCL upward
X direction
X
X
X X X X
X X
X X X X X
Centreline X X
X X X X
X
X

LCL 7 points in a
downward
direction

This rule applies to run charts and control charts 11

 Identifying special cause variation - zig zag

UCL

X X
X X
X X X X
X X
X X X
Centreline
X X X X X
X X X
X X

LCL

14 or more decreasing and

increasing alternately

This rule applies to run charts and control charts 12

 Identifying special cause variation - cyclical pattern

UCL
X X
X
X
X X
X X
X X
Centreline X X
X
X
X X

X X
X X X
LCL

This rule applies to run charts and control charts 13

 Identifying special cause variation - control Limits

Point
X above
UCL
UCL
X X
X
X X
X
X X
Centreline X
X
X
X X X
X X
X X

LCL Point
below X
LCL

This rule applies to control charts 14

 Identifying special cause variation - middle thirds
Considerably more than 2/3 of all the
points fall in this zone
UCL
X
X X
X X
X XX
X X
X X X X X
X X
X X
Centreline X X
X X X XX X X
X X X
X X X
X X XX X
X X X
X
LCL

Considerably less than 2/3 of all the

points fall in this zone This rule applies to control charts 15
Appropriate action
All process have variation. How you deal with this variation will depend on your findings. Here are
some general rules:

1. If the system is under control (no special-cause variation) and operating at an appropriate
level, no action is necessary. However, you may still seek to further improve performance.
2. If the system is operating at an appropriate level but there is special-cause variation, then
investigating the cause may be appropriate.
3. If the system is under control but operating at an inappropriate level (for example, targets
not met or performance is poor when compared to peers), it may be necessary to change the
system.
4. In some situations, a system may be neither in-control nor operating at an appropriate level,
in which case tackling special-cause variation before altering the process may be necessary.

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References

Statistical process control method in public health intelligence, Julian Flowers,

APHO Technical Briefing, Dec 2007 Issue 2.
http://www.apho.org.uk/resource/item.aspx?RID=39445

Statistical process control,

NHS National Services Scotland
http://www.isdscotland.org/Health-Topics/Quality-Improvement/Statistical-Process-Control/

SPC for beginners, Richard Lendon

NHS Modernisation Agency

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