Development Of A Medication Safety Dashboard Aligned To National Quality Standards.

• By: DUNCAN, Gregory (Australia)
• Co-author(s): Mr Gregory Duncan (Monash University, Melbourne, Australia)
  Dr Michael Wybrow (Monash University, Melbourne, Australia)
  Dr David Taylor (Eastern Health, Box Hill, Australia)
  Ms Cathy Ngo (Monash University, Melbourne, Australia / Eastern Health, Box Hill, Australia)
  Dr Agnes Haryanto (Monash University, Melbourne, Australia)
  Mr David Cheng-Zarate (Monash University, Melbourne, Australia)
  Professor Peteris Darzins (Monash University, Melbourne, Australia / Eastern Health, Box Hill, Australia)
  Dr David Taniar (Monash University, Melbourne, Australia)
  Mr Paul Adcock (Eastern Health, Box Hill, Australia)
  Ms Karen Mardegan (Eastern Health, Box Hill, Australia)
  Mr James Burns (Eastern Health, Box Hill, Australia)
  Professor Ian Davis (Monash University, Melbourne, Australia / Eastern Health, Box Hill, Australia)
  
• Abstract:

  Background: In Australia, the National Safety and Quality Health Service (NSQHS) Standards provide a consistent statement of the level of care consumers can expect from health service organisations. Independent accreditation agencies assess a health service against these standards. Historically, assessment of meeting standards was conducted on a 3-year cycle. Health services expended significant resources in the months leading up to a manual assessment. Australia is now moving to short notice assessments requiring organisations to be constantly assessment-ready with internal monitoring capacity to ensure readiness for external review at any time. For this reason, automated, near real-time performance monitoring processes are needed.
  Purpose: The “Actionable Dashboards Project at Eastern Health” or ADaPt EH is a collaborative approach to address the challenges of both short notice assessments and near real time monitoring of standards internally. The objective was to generate near real time dashboards presenting relevant patient information from the Electronic Medical Record (EMR) in an easily accessible and digestible format that can be used by hospitals for monitoring clinical care and performance aligned to accreditation standards.
  Method: ADaPt EH used a co-design approach working with key stakeholders, in particular the health service and the accreditation agency, to identify accreditation related measures that could be generated from the EMR. Existing “scorecards” were utilised to prioritise measures of organisational importance. A secure data warehouse was created to house EMR data and the pre-computed accreditation measures, from which data processing and interactive data visualisation using PowerBI® was constructed. Health service Quality Managers, Clinical Risk Managers, and researchers conducted data validation. Qualitative feedback on dashboard content, design and functionality was gathered via focus groups and interviews with key hospital staff and accreditation agency assessors. The potential value of dashboards on quality-of-care outcomes, clinical governance and organisational performance monitoring was also explored.
  Results: We developed, validated, and implemented two interactive Medication Safety dashboards, a performance dashboard with 16 measures and a live monitoring dashboard with 2 measures. Evaluation with accreditation agency assessors and health service staff indicated high levels of enthusiasm for integrating into regular use. Dashboards were visually appealing with features such as trend observation over time being identified as particularly useful. The ability to drill down to data of a specific unit/ward and individual patient was highly valued. Overall, acceptance of dashboards occurred rapidly, and stimulated suggestions for other areas of dashboard development.
  Conclusion: This Medication Safety dashboard is part of a larger project to develop dashboards for each NSQHS standard. These dashboards will be used for longitudinal monitoring to assess measures of uptake and use, impacts on workloads, and use for short notice accreditation assessment. Health service staff indicate enthusiasm for the dashboards and a high level of willingness supporting their development and implementation.
  ADaPt EH is supported through the Digital Health Collaborative Research Centre (DHCRC)in Australia (DHCRC-0108), and has multiple partners including Monash University, Eastern Health, the Australian Council on Healthcare Standards, and the Victorian Department of Health. DHCRC is funded under the Commonwealth of Australia’s Cooperative Research Centres (CRC) Program.