HiQuiPs: Using dashboards to supercharge clinical care and quality improvement

Authors: Vinyas Harish, Alun Ackery


Dashboard from the 2015 Hollywood movie “The Martian” (source: https://territorystudio.com/project/the-martian/)

Odds are in your favorite sci-fi movie or TV show, a character spends time looking at a dashboard to determine their next course of action. However, dashboards are not limited to sci-fi! Many organizations across sectors make daily use of dashboards to run smoothly and work towards their goals. St. Michael’s Hospital of Unity Health Toronto has designed, developed, and ultimately deployed dashboards to solve real-world problems. Examples include supporting community partners by providing sentinel surveillance of outbreaks in the shelter system during COVID-19 and ensuring that providers know the status of imaging requests in the emergency department.


In this post, we introduce the role of dashboards in quality improvement (QI) and patient safety and provide an outline of what we will cover in this series.


What is a dashboard?

“I think we often talk about [a health informatics implementation] needing to be super slick… but often [it] can just be a tool that gathers the massive amount of data we collect and displays information in a much more simple, straightforward manner.” - Dr. Alun Ackery (Medical Director of Informatics and Technology, Unity Health Toronto)


Originally developed in the business world, dashboards ultimately summarize and integrate information from an organization to support higher-quality decision-making.(1) Within clinical settings, dashboards can either serve clinical or QI purposes. Clinical dashboards inform direct, daily decisions in patient care.(1) QI dashboards provide an overview of identified QI and patient safety metrics at the institutional level and are used to monitor institutional performance against set goals.(2) There is evidence to suggest that QI dashboards can improve a wide range of outcomes such as infection rates, falls, and medication errors.(3-6) Both clinical and QI dashboards can integrate with existing health information technology systems, such as the electronic medical record.


What makes a good dashboard?

Key qualities of effective dashboards include:(2)

  1. Providing content in line with user needs

  2. Being easily comprehensible (i.e., at a glance)

  3. Being customizable depending on different user needs/wants

  4. Display timely and trustworthy data (i.e., that is perceived as valid and reliable)

  5. Being actionable (i.e., warning or notifying users when values are outside normal or acceptable limits)

How do you go about building a dashboard?

Dashboards, like any other health information technology implementation, require navigating a complex interplay of technology, culture, and context.(7) In the following series, we synthesize lessons learned across interviews with clinicians, software developers, and project managers at St. Michael’s Hospital in Toronto to learn about how they design and deploy dashboards to solve real-world clinical and QI problems. Our series will feature four posts:

  • Post 1 - Identifying a problem that a dashboard may help solve

  • Post 2 - Designing a good dashboard

  • Post 3 - Building your dashboard

  • Post 4 - Maintaining your dashboard and using it to the fullest potential

Let us know what you think on Twitter at @Hi_Qui_Ps. If there is anything specific you would like to learn about, e-mail us at hiquips@gmail.com. We look forward to having you as we explore the world of dashboards!


Senior Editor: Shawn Mondoux

Copyedited by: Vinyas Harish


References

  1. Dowding D, Randell R, Gardner P, Fitzpatrick G, Dykes P, Favela J, et al. Dashboards for improving patient care: Review of the literature. International Journal of Medical Informatics. 2015;84(2):87–100.

  2. Weggelaar-Jansen AM, Broekharst DS, de Bruijne M. Developing a hospital-wide quality and Safety Dashboard: A qualitative research study. BMJ Quality & Safety. 2018;27(12):1000–7.

  3. Dykes PC, Carroll DL, Hurley A, Lipsitz S, Benoit A, Chang F, et al. Fall prevention in acute care hospitals. JAMA. 2010;304(17):1912.

  4. Linder JA, Schnipper JL, Tsurikova R, Yu DT, Volk LA, Melnikas AJ, et al. Electronic Health Record Feedback to Improve Antibiotic Prescribing for Acute Respiratory Infections. Am J Manag Care. 2010 Dec;16(12 Suppl HIT):e311-9.

  5. Zaydfudim V, Dossett LA, Starmer JM, Arbogast PG, Feurer ID, Ray WA, et al. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle. Archives of Surgery. 2009;144(7):656.

  6. Waitman LR, Phillips IE, McCoy AB, Danciu I, Halpenny RM, Nelsen CL, et al. Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy. The Joint Commission Journal on Quality and Patient Safety. 2011;37(7).

  7. Jamieson T, Mamdani MM, Etchells E. Linking quality improvement and health information technology through the QI-hit figure 8. Applied Clinical Informatics. 2019;10(03):528–33.










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