www.PosterPresentations.com Background A Dynamic Electronic Medical Record Based Dashboard to Insure Inpatient Quality & Safety University of Washington and Harborview Medical Centers, Seattle, WA Barry Aaronson MD FACP FHM Hospitalist Associate Medical Director of Clinical Informatics Virginia Mason Medical Center National Library of Medicine Post-Doc Medical Informatics Research Fellow University of Washington Seattle, Washington [email protected] (206) 859-9573 Barry Aaronson MD, David Stone, Matthew Schaft, Derk Adams. Astrid Schreuder PhD, Gene Peterson MD PhD, Christine Cottingham RN, Margaret Neff MD, Keri Nasenbeny RN, J Richard Goss MD, Grant Fletcher MD, Erik Van Eaton MD Hospitals are required to report performance on multiple key quality and safety measures to government entities. Performance data on many of these measures is publicly available at hospitalcompare.gov and whynotthebest.org. Performance on most of these measures at even the highest performing hospitals is suboptimal. Efforts to improve performance on these measures traditionally involve analysis and presentation of retrospective reports of performance data at hospital meetings and conferences. This system of delayed reporting of performance has limited success with improving performance. Creating group situational awareness of real time patient status can achieve 100% compliance with quality and safety goals. Hypothesis Intervention We created within the Electronic Health Record (EHR, Cerner) a real time dashboard (using MPages) that will display on wall mounted monitors real time status of compliance with selected quality and safety measures. Any data that is hard coded (discrete data elements) can be accessed by this dashboard. The setting for this initial pilot is one ICU at the University of Washington Medical Center and 1 ICU at Harborview Medical Center. Setting This dashboard that enhances real time situational awareness for the entire care team has the potential to significantly improve compliance with safety and quality measures and therefore improve quality and safety of care. Clinical trials and qualitative evaluation of user experience are required to validate this new technology. Conclusion •The initial pilot for the Dashboard will be evaluated by analysis of before and after compliance reports. •Measurement of most of these parameters was already in place prior to development of dashboard. •Tracking of Dashboard data creates a new reporting tool for monitoring of compliance rates over time. •Qualitative assessment of end user acceptance of technology innovation will be included. Evaluation Selection of Parameters Quality Coordinating Committee Medical Directors CFO Nursing Leadership Others Dashboard Working Group IT Experts ICU Nurse Managers Informatics Physicians Clinical Expert Group Parameter 1 Project Management Cerner Leadership Committee CIO CMIO Cerner Project Manager Others Clinical Expert Group Parameter 2 Clinical Expert Group Parameter 3 Color Legend Compliant Partial Compliance Not Compliant Admit < 24 hrs Dashboard In Situ Governance Contact Info •Provides Real Time Group Situational Awareness of Multiple Parameters at a single glance •Deploying in 2 ICUs Properties •Refreshes Every 5 Minutes •Documenting “Not Indicated” or “Contraindicated” turns box green. •Hover over reveals last 6 values •Clicking on a score opens a window that shows the last 10 results and trend graphs Column Legend HOB= Head of Bed SBT= Spontaneous Breathing Trial VILI= Ventilator Induced Lung Injury

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Page 1: A Dynamic Electronic Medical Record Based Dashboard to

www.PosterPresentations.com

Background

A Dynamic Electronic Medical Record Based Dashboard to Insure Inpatient Quality & Safety University of Washington and Harborview Medical Centers, Seattle, WA

Barry Aaronson MD FACP FHM Hospitalist Associate Medical Director of Clinical Informatics Virginia Mason Medical Center National Library of Medicine Post-Doc Medical Informatics Research Fellow University of Washington Seattle, Washington [email protected] (206) 859-9573

Barry Aaronson MD, David Stone, Matthew Schaft, Derk Adams. Astrid Schreuder PhD, Gene Peterson MD PhD, Christine Cottingham RN, Margaret Neff MD, Keri Nasenbeny RN, J Richard Goss MD, Grant Fletcher MD, Erik Van Eaton MD

Hospitals are required to report performance on multiple key quality and safety measures to government entities. Performance data on many of these measures is publicly available at hospitalcompare.gov and whynotthebest.org. Performance on most of these measures at even the highest performing hospitals is suboptimal. Efforts to improve performance on these measures traditionally involve analysis and presentation of retrospective reports of performance data at hospital meetings and conferences. This system of delayed reporting of performance has limited success with improving performance.

Creating group situational awareness of real time patient status can achieve 100% compliance with quality and safety goals.

Hypothesis

Intervention

We created within the Electronic Health Record (EHR, Cerner) a real time dashboard (using MPages) that will display on wall mounted monitors real time status of compliance with selected quality and safety measures. Any data that is hard coded (discrete data elements) can be accessed by this dashboard.

The setting for this initial pilot is one ICU at the University of Washington Medical Center and 1 ICU at Harborview Medical Center.

Setting

This dashboard that enhances real time situational awareness for the entire care team has the potential to significantly improve compliance with safety and quality measures and therefore improve quality and safety of care. Clinical trials and qualitative evaluation of user experience are required to validate this new technology.

Conclusion

• The initial pilot for the Dashboard will be evaluated by analysis of before and after compliance reports. • Measurement of most of these parameters was already in place prior to development of dashboard. • Tracking of Dashboard data creates a new reporting tool for monitoring of compliance rates over time. • Qualitative assessment of end user acceptance of technology innovation will be included.

Evaluation

Selection of Parameters Quality Coordinating Committee Medical Directors CFO Nursing Leadership Others

Dashboard Working Group IT Experts ICU Nurse Managers Informatics Physicians

Clinical Expert Group Parameter 1

Project Management Cerner Leadership Committee CIO CMIO Cerner Project Manager Others

Clinical Expert Group Parameter 2

Clinical Expert Group Parameter 3

Color Legend Compliant Partial Compliance Not Compliant Admit < 24 hrs

Dashboard

In Situ Governance

Contact Info

• Provides Real Time Group Situational Awareness of Multiple Parameters at a single glance • Deploying in 2 ICUs

Properties • Refreshes Every 5 Minutes • Documenting “Not Indicated” or “Contraindicated” turns box green. • Hover over reveals last 6 values • Clicking on a score opens a window that shows the last 10 results and trend graphs

Column Legend HOB= Head of Bed SBT= Spontaneous Breathing Trial VILI= Ventilator Induced Lung Injury