Evolving Dashboards: Honing Metrics by Engaging Stakeholders

Background: Project dashboards provide necessary insight to the impact and value of patient-centered programs in a health care system. When aptly constructed, administration can utilize the dashboard to create a positive feedback loop that enables rapid learning and adaptation. Challenges in creating and modifying a dashboard are common, particularly when information and resources are limited. This can lead to misinterpretation of data and staff frustration. We established a partnership between Sutter Health’s Research, Development and Dissemination department and the case managers at a two-campus hospital in Alameda County, California, to reconstruct their organizational dashboard. We describe the process and lessons learned. Methods: The original dashboard was framed into four sections, three describing specific initiatives and one addressing secondary outcomes. To evolve the dashboard, we used an iterative and heuristic process, convening several meetings focused on methodically discussing the value of each section and metric. During these conversations, we engaged the stakeholders by soliciting the function of each initiative as well as the merit of each metric. After discussing which metrics were vital, we created a visual report showing trends in the identified data elements. We then presented the new dashboard to a group of stakeholders and elicited feedback. Results: Preserving much of the earlier framework, modifications were primarily focused on the metrics. We removed all target values and deprecated metrics that were no longer relevant to the program. Some measurements were redefined to more accurately represent program-impact goals while other metrics remained unchanged. Feedback was generally positive and produced productive dialogues concerning program aims and future states. Conclusion: By taking the time to understand the objectives of the program as well as the strategy, we produced a dashboard that enabled our colleagues to make organizational decisions and identify program successes and weaknesses. The evaluation of each metric ensured goal-alignment and justification, thereby eliminating confusion about program intentions and limitations. Additionally, visuals helped focus conversations around key aspects and outcomes, thereby enabling stakeholders to communicate advancements in a cogent manner. Though they require time and flexibility, dashboards are instrumental in reporting on the health of system initiatives