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

BMJ Open Quality

article

Baneen Alhmoud¹  Daniel Melley²  Nadeem Khan²  Timothy Bonicci¹  Riyaz Patel¹  Amitava Banerjee¹ 

[1] Institute of Health Informatics , University College London;Department of Intensive Care , Barts Health NHS Trust;Department of Intensive Care , University College London Hospitals NHS Foundation Trust;Department of Cardiology , University College London Hospitals NHS Trust

关键词: Clinical Audit;    COVID-19;    Standards of care;    Quality improvement;    Critical care;   

DOI  :  10.1136/bmjoq-2022-002033

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Background The 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.Objective To develop and evaluate a real-time dashboard of deteriorating patients’ assessment, referral and therapy.Settings Five academic hospitals in the largest National Health Service (NHS) trust in the UK (Barts Health NHS Trust).Intervention5, 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.Design Mixed methods: (1) virtual, face-to-face, interviews and (2) retrospective descriptive EHR data analysis.Results We 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).Conclusion The 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.

【 授权许可】

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