Quality Dashboards
78 Posts
Quality Enthusiasts,
I'm in the process of proposing dashboards for our hospital medicine group.
What does your group keep on your dashboard?
Do you have a different elements on the dashboard for leadership monitoring opposed to an individual hospitalist trying to monitor their care / performance
In the ideal world (collectable in the EMR, IT can design it, etc.) what elements would you like to see on an individual provider dashboard to help you provide high quality care?
Thanks for the information and brainstorming.
Justin
I'm in the process of proposing dashboards for our hospital medicine group.
What does your group keep on your dashboard?
Do you have a different elements on the dashboard for leadership monitoring opposed to an individual hospitalist trying to monitor their care / performance
In the ideal world (collectable in the EMR, IT can design it, etc.) what elements would you like to see on an individual provider dashboard to help you provide high quality care?
Thanks for the information and brainstorming.
Justin
7 Replies
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41 Posts
Hi Justin.
The ideal scenario is to have a business intelligence service to feed information on a routine basis.
At our institution the high level quality dashboard includes: LOS, HCAHPS scores, % of patients in observation, hand hygiene compliance, HAI rates (CLABSI, CAUTI, Cdiff), Readmissions by cause (30 days all, CHF, AMI, COPD, Pneumonia).
Most relevant focus have been around readmissions control, and we have found strong evidence on implementation of a COPD care path - which essentially integrates evidence based management (all patients D/C with LAMA/LABA) along with strong coordination of care for transitions (COPD post-D/C clinic) - with a decrease in its readmissions.
We have a monthly quality meeting, which each regional hospital presents its performance and compare with the previous quarters (a year comparison to date).
Is relevant to state that attribution of performance per provider is often directed to the discharging physician; this may be unfair in outlier performance cases. But there is not a perfect database.
The ideal scenario is to have a business intelligence service to feed information on a routine basis.
At our institution the high level quality dashboard includes: LOS, HCAHPS scores, % of patients in observation, hand hygiene compliance, HAI rates (CLABSI, CAUTI, Cdiff), Readmissions by cause (30 days all, CHF, AMI, COPD, Pneumonia).
Most relevant focus have been around readmissions control, and we have found strong evidence on implementation of a COPD care path - which essentially integrates evidence based management (all patients D/C with LAMA/LABA) along with strong coordination of care for transitions (COPD post-D/C clinic) - with a decrease in its readmissions.
We have a monthly quality meeting, which each regional hospital presents its performance and compare with the previous quarters (a year comparison to date).
Is relevant to state that attribution of performance per provider is often directed to the discharging physician; this may be unfair in outlier performance cases. But there is not a perfect database.
49 Posts
Justin,
This is certainly an area a lot of us struggle with. Our hospital pushed out a physician-level metric dashboard to the entire hospital. It utilizes the metrics that the hospital has been monitoring at a higher level. In our hospitalist group, based on our admitting cycles and average length of stay, it is really difficult to achieve meaningful attribution for encounter level metrics, such as O-E LOS, Readmission Rate, and Patient Satisfaction.
We are working on creating opportunities for clear attribution metrics. These are typically process measures, such as orders within a specified treatment pathway, as Moises described for COPD at his institution. This will require dedicated data pull requests and/or the use of newly minted Epic Physician Builders within our group.
I am really interested on the experiences of others as well.
Thanks,
Matt
This is certainly an area a lot of us struggle with. Our hospital pushed out a physician-level metric dashboard to the entire hospital. It utilizes the metrics that the hospital has been monitoring at a higher level. In our hospitalist group, based on our admitting cycles and average length of stay, it is really difficult to achieve meaningful attribution for encounter level metrics, such as O-E LOS, Readmission Rate, and Patient Satisfaction.
We are working on creating opportunities for clear attribution metrics. These are typically process measures, such as orders within a specified treatment pathway, as Moises described for COPD at his institution. This will require dedicated data pull requests and/or the use of newly minted Epic Physician Builders within our group.
I am really interested on the experiences of others as well.
Thanks,
Matt
59 Posts
Thank you for this very useful thread.
I just shared our Length of stay dashboard that we use for our system. It is broken down to campus, units, services as by LOS groups. Also, it reflects number of discharges, percent of discharges before 3 pm, number of long stay discharges,etc.
We are planning on encorporating DRG based LOS in our dashboard as well. Also we use daily throughput report that reflects unit based daily discharges, daily admissions, Month to date LOS and number case on each unit with LOS>5 days. The daily throughput card is distributed to all MDs and Nurse managers every day, the Dashboard I am sharing is distributed weekly. I would love to see examples of your dashboards.
I just shared our Length of stay dashboard that we use for our system. It is broken down to campus, units, services as by LOS groups. Also, it reflects number of discharges, percent of discharges before 3 pm, number of long stay discharges,etc.
We are planning on encorporating DRG based LOS in our dashboard as well. Also we use daily throughput report that reflects unit based daily discharges, daily admissions, Month to date LOS and number case on each unit with LOS>5 days. The daily throughput card is distributed to all MDs and Nurse managers every day, the Dashboard I am sharing is distributed weekly. I would love to see examples of your dashboards.
204 Posts
Hi,
I think this is a very important topic for focus by this group, as more and more health systems are looking at provider specific metrics/dashboards. We have metric like LOS, Readmission rate, and CMI on our dashboard. As we know attribution of metrics is a challenge, as some are better useful and appropriate as group metrics as opposed to attributing them to individual providers.
Rupesh.
I think this is a very important topic for focus by this group, as more and more health systems are looking at provider specific metrics/dashboards. We have metric like LOS, Readmission rate, and CMI on our dashboard. As we know attribution of metrics is a challenge, as some are better useful and appropriate as group metrics as opposed to attributing them to individual providers.
Rupesh.
1 Posts
Hi all,
Our division is in the process of developing an individual provider feedback dashboard. We have an embedded "Data Core" which consists of clinical informaticists and non-clinical informaticists that help us pull data from our EHR (epic) via clarity.
We are certainly in the early stages, but some metrics that we are planning to show include discharge summary timeliness, 7-day readmission rate, depth of coding (Level 1 H&P/total H&P's), diagnostic spending per patient day, and LOS - which we are using a surrogate metric "Discharge ratio" = Total number of patient-days worked / Total number of discharges. This was inspired inspired by this article: https://acphospitalist.org/archives/2014/10/los.htm. We are trying to strike a balance of discharge, throughput, clinical, financial/value metrics.
We were also inspired by Daniel Brotman's work at Johns Hopkins, including this paper on attribution (which has an image of their dashboard): https://www.journalofhospitalmedicine.com/jhospmed/article/154292/hospital-medicine/method-attributing-patient-level-metrics-rotating
Hope that is helpful!
- Sajan Patel
UCSF Division of Hospital Medicine
Our division is in the process of developing an individual provider feedback dashboard. We have an embedded "Data Core" which consists of clinical informaticists and non-clinical informaticists that help us pull data from our EHR (epic) via clarity.
We are certainly in the early stages, but some metrics that we are planning to show include discharge summary timeliness, 7-day readmission rate, depth of coding (Level 1 H&P/total H&P's), diagnostic spending per patient day, and LOS - which we are using a surrogate metric "Discharge ratio" = Total number of patient-days worked / Total number of discharges. This was inspired inspired by this article: https://acphospitalist.org/archives/2014/10/los.htm. We are trying to strike a balance of discharge, throughput, clinical, financial/value metrics.
We were also inspired by Daniel Brotman's work at Johns Hopkins, including this paper on attribution (which has an image of their dashboard): https://www.journalofhospitalmedicine.com/jhospmed/article/154292/hospital-medicine/method-attributing-patient-level-metrics-rotating
Hope that is helpful!
- Sajan Patel
UCSF Division of Hospital Medicine