Fox Lindsay Anne, Walsh Kathleen E, Schainker Elisabeth G
Department of Pediatrics, Tufts Medical Center Floating Hospital for Children, Boston, Massachusetts; and
James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Hosp Pediatr. 2016 Jul;6(7):412-9. doi: 10.1542/hpeds.2015-0222. Epub 2016 Jun 3.
Leaders of pediatric hospital medicine (PHM) recommended a clinical dashboard to monitor clinical practice and make improvements. To date, however, no programs report implementing a dashboard including the proposed broad range of metrics across multiple sites. We sought to (1) develop and populate a clinical dashboard to demonstrate productivity, quality, group sustainability, and value added for an academic division of PHM across 4 inpatient sites; (2) share dashboard data with division members and administrations to improve performance and guide program development; and (3) revise the dashboard to optimize its utility.
Division members proposed a dashboard based on PHM recommendations. We assessed feasibility of data collection and defined and modified metrics to enable collection of comparable data across sites. We gathered data and shared the results with division members and administrations.
We collected quarterly and annual data from October 2011 to September 2013. We found comparable metrics across all sites for descriptive, productivity, group sustainability, and value-added domains; only 72% of all quality metrics were tracked in a comparable fashion. After sharing the data, we saw increased timeliness of nursery discharges and an increase in hospital committee participation and grant funding.
PHM dashboards have the potential to guide program development, mobilize faculty to improve care, and demonstrate program value to stakeholders. Dashboard implementation at other institutions and data sharing across sites may help to better define and strengthen the field of PHM by creating benchmarks and help improve the quality of pediatric hospital care.
儿科医院医学(PHM)的领导者建议使用临床仪表盘来监测临床实践并进行改进。然而,迄今为止,尚无项目报告称已实施包含多个地点提议的广泛指标的仪表盘。我们试图:(1)开发并填充一个临床仪表盘,以展示一个学术性儿科医院医学部门在4个住院地点的生产力、质量、团队可持续性和附加值;(2)与部门成员和管理层共享仪表盘数据,以提高绩效并指导项目发展;(3)修订仪表盘以优化其效用。
部门成员根据儿科医院医学的建议提出了一个仪表盘。我们评估了数据收集的可行性,并定义和修改了指标,以便能够在各地点收集可比数据。我们收集了数据,并将结果与部门成员和管理层分享。
我们收集了2011年10月至2013年9月的季度和年度数据。我们在描述性、生产力、团队可持续性和附加值领域的所有地点都找到了可比指标;所有质量指标中只有72%以可比方式进行跟踪。在分享数据后,我们看到新生儿出院的及时性有所提高,医院委员会的参与度和资助资金有所增加。
儿科医院医学仪表盘有潜力指导项目发展,动员教职员工改善护理,并向利益相关者展示项目价值。在其他机构实施仪表盘并在各地点共享数据,可能有助于通过创建基准更好地定义和加强儿科医院医学领域,并有助于提高儿科医院护理质量。