Difference between revisions of "Dashboard"

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Submitted by Jonathan Sachs
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[[Category:BMI512-FALL-19]]

Revision as of 08:14, 21 October 2019

A Clinical dashboard or quality dashboard display data relating the real-time condition of a patient cohort or the status of performance indicators in a visually concise and usable interface. Dashboards are used for clinical decision support or to otherwise improve healthcare quality, efficiency, and safety.

A clinical dashboard often summarizes information from an associated electronic health record (EHR) into aggregate metrics, such as performance or quality indicators, to provide feedback to clinicians and managers at the point of decision making.


History and Terminology

Dashboards were developed in the business sector as a way to "summarize and integrate key performance information across an organization into a visual display as a way of informing operational decision making". [1]

The terms "registry" and "dashboard" are often used interchangeably in the literature. However, the term "clinical data registry" is usually in reference to viewing a retrospective patient cohort for the purposes of research or quality improvement. The data collected by a registry can have multiple sources, providing information about a patient's longitudinal care. The information is not necessarily displayed with an interface intending on real-time decision making.

Clinical dashboards provide point-of-care feedback to administrators, physicians, nurses, pharmacists, and other ancillary staff.


End-Users of Dashboards

  • Healthcare organizations (ie hospitals, clinics, and government bodies) to monitor performance and quality indicators.
  • Hospital administrators for patient placement and flow.
  • Physicians for monitoring their patient panels, whether in a hospital unit or outpatient clinic.
  • Pharmacists to assess medication use for potential errors, supply issues, and to safeguard against over-use as with antibiotic stewardship programs.
  • Care managers for coordinating discharge and follow up.
  • Ancillary staff for scheduling, transport, and more.


Use Cases and Examples

Outpatient Clinic

Primary care clinic physician: Monitoring of patient panels, identifying high-risk or high-cost patinets Specialty clinic physician: Medical assistant, schedulers:

Hospital

Acute Care Physician: Monitoring assigned patient list, rounding support Intensive care unit physician: Monitoring for compliance with ventilator and line saefty bundles Emergency Department physician: Surgeon: Health Unit Coordinator (HUC):

Pharmacist: Potential adverse drug event dashboard to highlight high-risk medication scenarios.

Hospital Administration: Command center Physician leadership: High-risk patient dashboards displaying those with elevated creatinine, positive line cultures. Quality

Population Health

Coordinated Care Organizations: Public health departments:

Effects on Workflows

Benefits of clinical dashboard utilization

  • Reduced information overload, simplification of clinical data
  • Improved ability to find information effectively
  • Provides clinical decision support, guiding clinicians on the priority of care and on the priorities of the organization.
  • Facilitates communication between providers caring for common patients

Unintended consequences of clinical dashboard utilization

  • Tunnel vision: Focusing on the metrics that are displayed, while ignoring other unmeasured indicators
  • Measurement fixation: Focusing on improving the quantitative representation of performance and quality (meeting the target number), rather than on the overarching purpose of care.


Design Considerations

The presentation of information affects the decisions of end-users.

Visualization

Additional information about the urgency of data can be imparted using color coding, or with symbols such as warning signs or traffic lights. Recent trends can be simplified on a dashboard display using spark-lines.

Accessibility

An emergency department may have a large screen permanently displaying the ED census and important metrics, such as abnormal vitals, and bed assignments, and notes from staff. A dashboard can be a screensaver or the first page when logging into an EHR. Studies of dashboard implementation have shown that difficult or inconvenient accessing is a major impediment to their usage. [1]

Interaction

The dashboard should allow for convenient linking to more detailed information, by allowing the user to hover for expanded data or click to access that element in the patient's chart.

Risk Scoring

References

  1. 1.0 1.1 Dowding D, Randell R, Gardner P, et al. Dashboards for improving patient care: review of the literature. Int J Med Inf. 2015;84(2):87-100.

Submitted by Jonathan Sachs