Evaluating a novel, integrative dashboard for health professionals’ performance in managing deteriorating patients:a quality improvement project

Abstract

BackgroundThe quality of recording and documentation of deteriorating patient management by health professionals has been challenged during the COVID-19 pandemic. Non-adherence to escalation and documentation guidelines increases risk of serious adverse events. Electronic health record (EHR)-integrated dashboards are auditing tools of patients’ status and clinicians’ performance, but neither the views nor the performance of health professionals have been assessed, relating to management of deteriorating patients.ObjectiveTo develop and evaluate a real-time dashboard of deteriorating patients’ assessment, referral and therapy.SettingsFive academic hospitals in the largest National Health Service (NHS) trust in the UK (Barts Health NHS Trust).InterventionThe dashboard was developed from EHR data to investigate patients with National Early Warning Score (NEWS2)>5, assessment, and escalation of deteriorating patients. We adopted the Plan, Do, Study, Act model and Standards for Quality Improvement Reporting Excellence framework to evaluate the dashboard.DesignMixed methods: (1) virtual, face-to-face, interviews and (2) retrospective descriptive EHR data analysis.ResultsWe interviewed three nurses (two quality and safety and one informatics specialists). Participants perceived the dashboard as a facilitator for auditing NEWS2 recording and escalation of care to improve practice; (2) there is a need for guiding clinicians and adjusting data sources and metrics to enhance the functionality and usability. Data analysis (2019–2022) showed: (1) NEWS2 recording has gradually improved (May 2021–April 2022) from 64% to 83%;(2) referral and assessment completion increased (n: 170–6800 and 23–540, respectively).ConclusionThe dashboard is an effective real-time data-driven method for improving the quality of managing deteriorating patients. Integrating health systems, a wider analysis NEWS2 and escalation of care metrics, and clinicians’ learning digital solutions will enhance functionality and experience to boost its value. There is a need to examine the generalisability of the dashboard through further validation and quality improvement studies.

Centralized Multipatient Dashboards' Impact on Intensive Care Unit Clinician Performance and Satisfaction: A Systematic Review

“…4,8,9 Previous research in this field has demonstrated that technological solutions, such as widely visible EMR-based dashboards for monitoring multiple patients may effectively reduce the time required to prioritize patients in need of immediate care, improve the accuracy of assigning priorities, and alleviate the cognitive burden on clinical staff. 10,11 These tools may facilitate team communication, overcoming the challenges of fragmented data, 4 and, by enhancing communication and situational awareness, also improve teamwork. 12 Research to date has primarily evaluated interfaces designed for individual use rather than those intended for display on a large screen and accessible by multiple users within a shared space.…”

“…EMR-based multi-patient dashboards have shown promise in supporting clinicians with their workload and improving situational awareness in the ICU [4,8,9] . Previous research in this field has demonstrated that technological solutions, such as widely visible EMR-based dashboards for monitoring multiple patients may effectively reduce the time required to prioritize patients in need of immediate care, improve the accuracy of assigning priorities, and alleviate the cognitive burden on clinical staff [10,11] . These tools may facilitate team communication, overcoming the challenges of fragmented data [4] , and, by enhancing communication and situational awareness, also improve teamwork [12] .…”

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“…Powerful antibiotics with a broad-spectrum can treat a range of infections and are particularly valuable when clinicians are uncertain about the exact cause. In an effort to surmount the intricate intricacies associated with this matter, anyone entering a hospital with clinical features is flagged as having sepsis and should be prescribed broad-spectrum antibiotics within an hour [48]. But this -better safe than sorry‖ approach can have unintended ramifications of AMR [49].…”

Analisis Pelaksanaan Komunikasi Efektif SBAR Perawat dan Dokter

“…Temuan ini koheren dengan studi di departemen rumah sakit yang berbeda di mana kursus Pendidikan Komunikasi Kolaboratif SBAR telah dilaksanakan. Dalam studi oleh (Alhmoud et al, 2022) penerapan SBAR terbukti membantu perawat lebih fokus dan memudahkan komunikasi mereka selama serah terima. Demikian pula, (Dalky et al, 2020) menemukan bahwa implementasi SBAR memiliki efek positif pada perawat kebidanan sehubungan dengan kepuasan kerja, kondisi kerja, iklim keselamatan, dan kerja tim.…”