clinical care, quality improvement, dashboards, design, health informatics, best practices

HiQuiPs: Using dashboards to supercharge clinical care and quality improvement

In HiQuiPs by Vinyas HarishLeave a Comment

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

Odds are in your favourite 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 [email protected]. We look forward to having you as we explore the world of dashboards!

Senior Editors: @shawn-mondeux and @ahmed-taher

This post was copyedited by Sydney Terry.

  1. 1.
    Dowding D, Randell R, Gardner P, et al. Dashboards for improving patient care: review of the literature. Int J Med Inform. 2015;84(2):87-100. doi:10.1016/j.ijmedinf.2014.10.001
  2. 2.
    Weggelaar-Jansen A, Broekharst D, de B. Developing a hospital-wide quality and safety dashboard: a qualitative research study. BMJ Qual Saf. 2018;27(12):1000-1007. doi:10.1136/bmjqs-2018-007784
  3. 3.
    Dykes P, Carroll D, Hurley A, et al. Fall prevention in acute care hospitals: a randomized trial. JAMA. 2010;304(17):1912-1918. doi:10.1001/jama.2010.1567
  4. 4.
    Linder J, Schnipper J, Tsurikova R, et al. Electronic health record feedback to improve antibiotic prescribing for acute respiratory infections. Am J Manag Care. 2010;16(12 Suppl HIT):e311-9. https://www.ncbi.nlm.nih.gov/pubmed/21322301
  5. 5.
    Zaydfudim V, Dossett L, Starmer J, et al. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle. Arch Surg. 2009;144(7):656-662. doi:10.1001/archsurg.2009.117
  6. 6.
    Waitman L, Phillips I, McCoy A, et al. Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy. Jt Comm J Qual Patient Saf. 2011;37(7):326-332. doi:10.1016/s1553-7250(11)37041-9
  7. 7.
    Jamieson T, Mamdani M, Etchells E. Linking Quality Improvement and Health Information Technology through the QI-HIT Figure 8. Appl Clin Inform. 2019;10(3):528-533. doi:10.1055/s-0039-1693456

Reviewing with the Staff

Dr. Mondoux is the Quality and Safety Lead of the Emergency Department at St. Joesph\'s Healthcare Hamilton (SJHH). He is also the Physician Innovation Lead for SJHH.

Dr. Shawn Mondoux

Alun Ackery

Dr. Alun Ackery is the Deputy Chief of the Emergency Medicine and the Co-Medical Director of Information and Technology at St. Michael’s Hospital, Unity Health Toronto. He completed his MD and MSc at the University of Toronto and continues as an Assistant Professor for the Department of Medicine, Division of Emergency Medicine. Alun has done extensive research on topics including injury prevention, trauma, and pre-hospital care.