Sheila Enright, RGN, Dip, BSc, MSc Clinical Placement Co-Ordinator, Beaumont Hospital

Transcription

1 Sheila Enright, RGN, Dip, BSc, MSc Clinical Placement Co-Ordinator, Beaumont Hospital Project Team: Maureen O Connell, Mary Coogan, Susan Hawkshaw, Barbara Levins Potter, Etaoin Donohoe, Stephen Winder.

2 Business Intelligence Analyst Developer Informatic Nurse Manager Nurse Practice Development CNM Stephen Winder Barbara Levins- Potter NPDC Maureen O Connell Sheila Enright Mary Coogan TVNS Susan Hawkshaw Etaoin Donohoe

3 A Clinical Dashboard is a toolset of visual displays developed to provide clinicians with the relevant and timely information they need to inform decisions that improve the quality of patient care (NHS, 2009)

4 Knowledge transfer is a means of communicating knowledge to relevant stakeholders through a variety of methods (Pentland et al, 2011), In healthcare, the use of Clinical dashboards to transfer knowledge are reported to drive change, enhance clinical performance, improve decision making and quality of care. (Chandrahan, 2010; Nutley et al, 2013; Clark et al, 2013)

5 Donabedian s Conceptual framework for Evaluating Quality of Care (1966) Linking process data with structure and outcomes measures is recommended to see the influence on quality of patient care (HSE, 2015) Clinical dashboards provide a platform where multiple sources of existing data, on structure, process and outcomes are utilised to provide a comprehensive picture of an organisation progress (NHS, 2007)

6 An action research group project. The HSE Change Model (2008) was utilised to guide the project The project team were also involved in the role out of Quality Care Metrics in the organisation. This was seen as an opportunity to link structure, process and outcome data. This project involved the development and implementation of a clinical dashboard for two pilot wards. A framework (SOP) was also developed to guide the utilisation and governance of the dashboards Since completion of the masters programme, membership of the project team has expanded, and work has continued on the development of an electronic dashboard. The electronic prototype is near completion. It has been developed to display data pertaining to pressure area care in our organisation as follows; Structure Data daily staffing levels Process Data -quality care metric results Outcome Data- the prevalence, grade and whether hospital/community acquired etc

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9 Organisational Perspective Increased Communication and information sharing,information is readily accessible, saving time Improve Quality of care/services Aid Clinical decision making Improved staff awareness Highlighted seasonal trends Allowing local configuration and comparison against national data sets Literature Improves communication of knowledge, access to information, (Daley et al, 2013; McLaughin et al, 2014, and Clark et al, 2013) Helps engage and improve communication between frontline staff and senior leaders; resulting in high level decision making processes and improvement in efficiency and quality of care for patients (Heenan et al,2012;clark et al, 2013). Key to gaining attention and changing behaviour (Meijer's et al, 2013) Raised awareness of problems/deficiencies in workforce training and clinical skills. (Guha et al, 2013) Instrumental in building business cases (Flannigan et al, 2012)

10 HSE Reports, DOHc Strategy/projects, HIQA, Hospital Strategy Governance Quality Metrics Improved Quality of care, Reduced length of stay Cost Saving Change Fatigue/Cultural Change/Interdisciplinary Stakeholder Engagement and support Shared Vision Resources-IT, Project Team Reliability/Quality of Data Cost Infrastructure Staff Access

11 To expand existing clinical dashboard To implement clinical dashboards across all clinical sites in the organisation, To build on the concept of Interdisciplinary clinical dashboards A Project Team to be released with key personnel to include IT personnel, business intelligence, nursing etc to facilitate the implementation of this project Dedicated IT resources and support for clinical dashboards Investment in the area of data quality; measures to ensure reliability and validity of data. Development of an education and training programme to create a culture of data usage.

12 Clark, K.W., Whiting, E., Rowland, J., Thompson, L.E., Missenden, I. and Schellein, G. (2013) Breaking the mould without breaking the system: the development and pilot of a clinical dashboard at the Prince Charles Hospital, Australian Health Review, 37, Daley, K., Richardson, J., James, I., Chambers, A. and Corbett, D. (2013) Clinical dashboard: use in older adult mental health wards, The Psychiatrist, 37, Donabedian, A (1969) Quality of care : problems of measurement. II. Some issues in evaluating the quality of nursing care, American Journal of Public Health and the Nations Health, 59(10), Flannigan, C., Toland, U. and Hogan, M. (2010) Dashboards in neonatology, Clinical Audit, 2, Guha, S., Hoo, W.P. and Bottomley, C. (2013) Introducing an acute gynaecology dashboard as a new clinical governance tool, Clinical Governance: An International Journal, 18(3), Health Services Executive (HSE) (2008) Improving our Services: A Users guide to Managing Change in the Health service Executive, Dublin:HSE Health Services Executive (HSE) (2015) Report on Feedback and Recommendations on Nursing and Midwifery Metrics from front-line Users, Dublin:HSE. Heenan, M., DiEmanuele, M., Hayward-Murray, K. and Dadgar, L. (2012) Hospital on a page: standardizing data presentation to drive quality improvement, Healthcare Quarterly, 15(1), McLaughlin, N., Afsar-manesh, N., Ragland, V., Buxey, F. and Martin, N.A. (2014) Trackinng and sustaining improvement initiatives: leveraging quality dashboards to lead change in a neurosurgical department, Neurosurgery, 74(3), NHS, (2009) Connecting for Health, Clinical Dashboards, leeds: NHS CFH Nutley, T., McNabb, S. and Salentine, S. (2013) Impact of a decision-support tool on decision making at the district level in Kenya, Health Research Policy and Systems, 11(34), 1-8. Meijers, J.M., Halfens, R.J. Mijnarends, D.M., Mostert, H. and Schols, J.M. (2013) A feedback system to improve the quality of nutritional care, Nutrition, 29, Pentland, D., Forsyth, K., Maciver, D., Walsh, M., Murray, R., Irvine, L. and Sikora, S. (2011) Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review, Journal of Advanced Nursing, 67(7),