DEVELOPMENT OF UNIT-BASED DASHBOARDS FOR COMMUNICATING NURSING QUALITY OF CARE DATA

Iatrogenic events such as patient falls, pressure injuries, central line infections and the spread of infectious diseases are largely preventable, yet they occur with unfortunate frequency in hospitals and other patient care environments throughout the nation. Nurses, as the predominant caregivers in healthcare facilities, are continually examining their practices, policies and procedures to prevent such events. However, due to the lack of robust systems and methodologies for systematically collecting, analyzing and communicating practice-related data, many attempts to improve care quality are hampered. Healthcare facilities struggle to find effective ways to communicate data to staff nurses providing care so that they can undertake analysis and improve their performance and the overall quality of care they provide. This project was developed to address the issue of quality of care feedback to staff nurses at the unit level. It involved designing and implementing unit-based dashboards to communicate performance data in a manner that would stimulate unit-based discussions related to care improvement. Discussion of performance data would in turn facilitate the engagement of staff nurses in planning effective care improvement interventions. The dashboards were developed with the involvement of nurse executives, managers and members of key departmental and unit-based committees. The dashboards were piloted over a three-month period on two nursing units (an ICU stepdown unit and a medical rehabilitation unit) at Rancho Los Amigos National Rehabilitation Hospital in Downey, California. As dashboards were created each month, their positive and negative attributes were identified, and suggested changes were incorporated as subsequent dashboards were produced. The project was evaluated in several ways. Pre and post-project questionnaires were administered to staff nurses on the two pilot units to assess their perceived level of involvement in receiving and utilizing quality of care data. The two pilot units were visited throughout the project to ascertain the actual physical presence of the dashboards, and minutes of unit-based “collaborative” committees were reviewed to determine if data were being shared and discussed. Additionally, nurse leaders and members of key nursing departmental and unit-based committees were queried as to their perceptions of the effectiveness of the dashboards in data communication. While, as revealed from analysis of pre and post-project questionnaires, there were no significant changes in staff-nurse perception of their involvement in quality of care activities, nurse executives and nurses on departmental and unit committees conveyed their strong belief that the dashboards could provide an effective tool for data communication. It was their expressed conviction that, as the department continued in its cultural transformation to become more data-focused, the dashboards would play an increasingly important role in providing important feedback that would assist staff nurses in designing and implementing evidence-based interventions to continually improve care quality