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开发全院范围的质量和安全仪表板:一项定性研究。

Developing a hospital-wide quality and safety dashboard: a qualitative research study.

机构信息

Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands.

Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

BMJ Qual Saf. 2018 Dec;27(12):1000-1007. doi: 10.1136/bmjqs-2018-007784. Epub 2018 Jun 27.

Abstract

BACKGROUND

Several countries have national policies and programmes requiring hospitals to use quality and safety (QS) indicators. To present an overview of these indicators, hospital-wide QS (HWQS) dashboards are designed. There is little evidence how these dashboards are developed. The challenges faced to develop these dashboards in Dutch hospitals were retrospectively studied.

METHODS

24 focus group interviews were conducted: 12 with hospital managers (n=25; 39.7%) and 12 support staff (n=38; 60.3%) in 12 of the largest Dutch hospitals. Open and axial codings were applied consecutively to analyse the data collected.

RESULTS

A heuristic tool for the general development process for HWQS dashboards containing five phases was identified. In phase 1, hospitals make inventories to determine the available data and focus too much on quantitative data relevant for accountability. In phase 2, hospitals develop dashboard content by translating data into meaningful indicators for different users, which is not easy due to differing demands. In phase 3, hospitals search for layouts that depict the dashboard content suited for users with different cognitive abilities and analytical skills. In phase 4, hospitals try to integrate dashboards into organisational structures to ensure that data are systematically reviewed and acted on. In phase 5, hospitals want to improve the flexibility of their dashboards to make this adaptable under differing circumstances.

CONCLUSION

The literature on dashboards addresses the technical and content aspects of dashboards, but overlooks the organisational development process. This study shows how technical and organisational aspects are relevant in development processes.

摘要

背景

一些国家制定了国家政策和方案,要求医院使用质量和安全(QS)指标。为了概述这些指标,设计了医院范围的质量和安全(HWQS)仪表板。几乎没有证据表明这些仪表板是如何开发的。本研究回顾性地研究了荷兰医院开发这些仪表板所面临的挑战。

方法

对 12 家最大的荷兰医院中的 12 家医院管理人员(n=25;39.7%)和 12 名支持人员(n=38;60.3%)进行了 24 次焦点小组访谈。连续应用开放式和轴向编码对收集的数据进行分析。

结果

确定了一个用于 HWQS 仪表板一般开发过程的启发式工具,包含五个阶段。在第 1 阶段,医院进行清查,以确定可用数据,并过于关注与问责制相关的定量数据。在第 2 阶段,医院通过将数据转化为不同用户的有意义的指标来开发仪表板内容,由于需求不同,这并不容易。在第 3 阶段,医院寻找适合不同认知能力和分析技能用户的仪表板内容布局。在第 4 阶段,医院尝试将仪表板整合到组织结构中,以确保数据系统地进行审查和采取行动。在第 5 阶段,医院希望提高仪表板的灵活性,以便在不同情况下进行调整。

结论

仪表板文献涉及仪表板的技术和内容方面,但忽略了组织发展过程。本研究表明技术和组织方面在开发过程中是相关的。

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