Dashboards for visual display of patient safety data: a systematic review

Murphy, Daniel R.; Savoy, April; Satterly, Tyler; Sittig, Dean F.; Singh, Hardeep

doi:10.1136/bmjhci-2021-100437

Cited by 13 publications

(15 citation statements)

References 43 publications

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“…Notably, there was a recent review on patient safety dashboards published in late 2021. 28 It analyzed 33 time-series studies and case studies and concluded limited evidence for dashboards directly or indirectly impacting patient safety.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of clinical dashboards as audit and feedback or clinical decision support tools on medication use and test ordering: a systematic review of randomized controlled trials

Xie

Chen

Hincapié

et al. 2022

Journal of the American Medical Informatics Association

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Background Clinical dashboards used as audit and feedback (A&F) or clinical decision support systems (CDSS) are increasingly adopted in healthcare. However, their effectiveness in changing the behavior of clinicians or patients is still unclear. This systematic review aims to investigate the effectiveness of clinical dashboards used as CDSS or A&F tools (as a standalone intervention or part of a multifaceted intervention) in primary care or hospital settings on medication prescription/adherence and test ordering. Methods Seven major databases were searched for relevant studies, from inception to August 2021. Two authors independently extracted data, assessed the risk of bias using the Cochrane RoB II scale, and evaluated the certainty of evidence using GRADE. Data on trial characteristics and intervention effect sizes were extracted. A narrative synthesis was performed to summarize the findings of the included trials. Results Eleven randomized trials were included. Eight trials evaluated clinical dashboards as standalone interventions and provided conflicting evidence on changes in antibiotic prescribing and no effects on statin prescribing compared to usual care. Dashboards increased medication adherence in patients with inflammatory arthritis but not in kidney transplant recipients. Three trials investigated dashboards as part of multicomponent interventions revealing decreased use of opioids for low back pain, increased proportion of patients receiving cardiovascular risk screening, and reduced antibiotic prescribing for upper respiratory tract infections. Conclusion There is limited evidence that dashboards integrated into electronic medical record systems and used as feedback or decision support tools may be associated with improvements in medication use and test ordering.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of clinical dashboards as audit and feedback or clinical decision support tools on medication use and test ordering: a systematic review of randomized controlled trials

Xie

Chen

Hincapié

et al. 2022

Journal of the American Medical Informatics Association

View full text Add to dashboard Cite

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“…A recent systematic review comprised of 33 clinical dashboard evaluation studies reported that only four had leveraged human factors principles during development. 16 The challenge with following a human-centered design approach becomes apparent in cases where the target group of clinician end users experiences periodic turnover, meaning, the clinicians that played a role in the initial development process of the dashboard may not be the same individuals that use the dashboard in the future. 17 Thus, it emphasizes the need for a development framework that contains a continual feedback mechanism, even after the dashboard is made available for routine use.…”

Section: Background and Significancementioning

confidence: 99%

Developing the VA Geriatric Scholars Programs' Clinical Dashboards Using the PDSA Framework for Quality Improvement

et al. 2022

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Background Involving clinician end users in the development process of clinical dashboards is important to ensure that user needs are adequately met prior to releasing the dashboard for use. The challenge with following this approach is that clinician end users can undergo periodic turnover, meaning, the clinicians that played a role in the initial development process may not be the same individuals that use the dashboard in future. Objectives Here, we summarize our Plan, Do, Study, Act (PDSA)-guided clinical dashboard development process for the VA Geriatric Scholars Program (GSP) and the value of continuous, iterative development. We summarize dashboard adaptations that resulted from two PDSA cycles of improvement for the potentially inappropriate medication dashboard (PIMD), one of many Geriatric Scholars clinical dashboards. We also present the evaluative performance of the PIMD. Methods Evaluation of the PIMD was performed using the system usability scale (SUS) and through review of user interaction logs. Routine end users that were Geriatric Scholars and had evidence of 5 or more dashboard views were invited to complete an electronic form that contained the 10-item SUS. Results The proportion of Geriatric Scholars that utilized the PIMD increased for each iterative dashboard version that was produced as a byproduct from feedback (31.0% in 2017 to 60.2% in 2019). The overall usability of the PIMD among routine users was found to be above average (SUS score: 75.2 [95% CI 70.5–79.8]) in comparison to the recommended standard of acceptability (SUS score: 68) Conclusion The solicitation of feedback during dashboard orientations led to iterative adaptations of the PIMD that broadened its intended use. The presented PDSA-guided process to clinical dashboard development for the VA GSP can serve as a valuable framework for development teams seeking to produce well-adopted and usable health information technology (IT) innovations.

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“…Open access process and performance quality metrics (eg, wait times) or human resource metrics (eg, staff turnover). 3 The use of quality and safety dashboards by healthcare organisations has demonstrated improvements in key quality and safety metrics including infection rates, 4 5 medication errors 6 and fall prevention. 7 The impetus for the quality improvement project followed the recommendations from external consultants brought in by the organisation.…”

Section: What This Study Addsmentioning

confidence: 99%

“…2 Dashboards containing key quality improvement and patient safety performance metrics are frequently employed by healthcare organisations to guide decisions and improve the organisation's structure, process and outcomes. 3 Most dashboards focus on specific quality and safety metrics and area(s) within a healthcare organisation (eg, hospitalacquired infections within a given unit),…”

Section: Introductionmentioning

confidence: 99%

“…In the drive to maintain quality and high performance, healthcare organisations frequently use dashboards to track and measure key performance indicators to gauge the organisation’s performance and guide decision making 2. Dashboards are visual information systems that disseminate data in a format that is easily interpreted by end users 2 3. A typical dashboard will display an overview of an organisation’s key performance measures to inform and guide decision making 2.…”

Section: Introductionmentioning

confidence: 99%

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How do we measure organisational wellness? Development of a comprehensive patient-centred and employee-centred visual analytical solution

et al. 2022

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BackgroundDashboards are visual information systems frequently employed by healthcare organisations to track key quality improvement and patient safety performance metrics. The typical healthcare dashboard focuses on specific metrics, disease processes or units within a larger healthcare organisation. Here, we describe the development of a visual analytical solution (keystone dashboard) for monitoring an entire healthcare organisation.MethodsThe improvement team reviewed and assessed various data sources across the organisation and selected a group of patient and employee related metrics that afforded a broad overview of the organisation’s well-being. Metrics spanned the organisation and included data from patient safety, quality improvement, human resources, risk management and medical staff affairs. Each metric was assigned a numeric weight that correlated with its impact. A visual model incorporating the various data fields was then constructed.ResultsThe keystone dashboard incorporates a data heatmap and density visualisation to emphasis areas of higher density and/or weighted values. The heatmap is used to indicate the weight/magnitude of each metric within a data range in two dimensions: location and time. The visualisation ‘heats up’ depending on the combination of counts events and their assigned impact for the reporting month. Most data sources update in near real time.SummaryThe keystone dashboard serves as a comprehensive and collaborative integration of data from patient safety, quality improvement, human resources, risk management and medical staff affairs. This visual analytical solution incorporates and analyses metrics into a single view with the intent of providing valuable insight into the health of an entire organisation. This dashboard is unique as it provides a broad overview of a healthcare organisation by incorporating key metrics that span the organisation.

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Dashboards for visual display of patient safety data: a systematic review

Cited by 13 publications

References 43 publications

Effectiveness of clinical dashboards as audit and feedback or clinical decision support tools on medication use and test ordering: a systematic review of randomized controlled trials

Effectiveness of clinical dashboards as audit and feedback or clinical decision support tools on medication use and test ordering: a systematic review of randomized controlled trials

Developing the VA Geriatric Scholars Programs' Clinical Dashboards Using the PDSA Framework for Quality Improvement

How do we measure organisational wellness? Development of a comprehensive patient-centred and employee-centred visual analytical solution

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