QualDash: Adaptable Generation of Visualisation Dashboards for Healthcare Quality Improvement

Randell, Rebecca; Brehmer, Matthew; McVey, Lynn; Alvarado, Natasha; Gale, Chris P; Ruddle, Roy A.

doi:10.1109/tvcg.2020.3030424

Cited by 38 publications

(33 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 34 Equally, we recognise that while information such as health-related quality of life may be difficult to capture via national registries, 35 greater alliance may help enhance the comprehensiveness of data collection systems in the UK. 36 37 …”

Section: Discussionmentioning

confidence: 99%

Quality of acute myocardial infarction care in England and Wales during the COVID-19 pandemic: linked nationwide cohort study

Aktaa

Yadegarfar

et al. 2021

BMJ Qual Saf

View full text Add to dashboard Cite

Background and objectiveThe impact of the COVID-19 pandemic on the quality of care for patients with acute myocardial infarction (AMI) is uncertain. We aimed to compare quality of AMI care in England and Wales during and before the COVID-19 pandemic using the 2020 European Society of Cardiology Association for Acute Cardiovascular Care quality indicators (QIs) for AMI.MethodsCohort study of linked data from the AMI and the percutaneous coronary intervention registries in England and Wales between 1 January 2017 and 27 May 2020 (representing 236 743 patients from 186 hospitals). At the patient level, the likelihood of attainment for each QI compared with pre COVID-19 was calculated using logistic regression. The date of the first national lockdown in England and Wales (23 March 2020) was chosen for time series comparisons.ResultsThere were 10 749 admissions with AMI after 23 March 2020. Compared with before the lockdown, patients admitted with AMI during the first wave had similar age (mean 68.0 vs 69.0 years), with no major differences in baseline characteristics (history of diabetes (25% vs 26%), renal failure (6.4% vs 6.9%), heart failure (5.8% vs 6.4%) and previous myocardial infarction (22.9% vs 23.7%)), and less frequently had high Global Registry of Acute Coronary Events risk scores (43.6% vs 48.6%). There was an improvement in attainment for 10 (62.5%) of the 16 measured QIs including a composite QI (43.8% to 45.2%, OR 1.06, 95% CI 1.02 to 1.10) during, compared with before, the lockdown.ConclusionDuring the first wave of the COVID-19 pandemic in England and Wales, quality of care for AMI as measured against international standards did not worsen, but improved modestly.

show abstract

Section: Discussionmentioning

confidence: 99%

Quality of acute myocardial infarction care in England and Wales during the COVID-19 pandemic: linked nationwide cohort study

Aktaa

Yadegarfar

et al. 2021

BMJ Qual Saf

View full text Add to dashboard Cite

show abstract

“…Audit and feedback may help reduce variations in care quality by comparing clinical performance against standards and benchmarks to stimulate data-driven improvement [ 3 ]. In the National Health Service (NHS) in England, national audit and feedback are part of a well-established quality improvement program that encompasses over 50 clinical specialties and patient groups [ 4 , 5 ]. Audit suppliers centrally collate and manage data from participating services and produce feedback, with national comparators, with the intention of stimulating quality improvement [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In health care, a distinction is made between clinical dashboards that display performance at the level of individual clinicians or patients to inform direct patient care and quality dashboards that show performance at the level of a ward or organization to inform service improvement [ 11 , 12 ]. Despite the increasing use of dashboards in health care, including as part of the recent response to COVID-19 [ 13 , 14 ], evidence regarding how they become integrated into work processes to impact practice is limited [ 5 ]. The aim of this study, therefore, is to investigate how, why, and to what extent a novel quality dashboard (QualDash) supported the use of national audit data for quality improvement in an English hospital setting.…”

Section: Introductionmentioning

confidence: 99%

“…QualDash is a customizable, web-based dashboard that was designed and evaluated using data from 2 national audits: The Myocardial Ischemia National Audit Project (MINAP) and the Pediatric Intensive Care Audit Network (PICANet). MINAP collects data spanning 130 data fields, contributed by all hospitals in England, Wales, and Northern Ireland that admit patients with acute coronary syndromes [ 15 , 16 ], whereas PICANet collects data from hospitals and services that transport critically ill children to pediatric intensive care units (PICUs) in England, Scotland, Wales, Ireland, and Northern Ireland [ 5 , 17 ]. These 2 audits vary in clinical specialty and metrics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of a Web-Based Dashboard to Support the Use of National Audit Data in Quality Improvement: Realist Evaluation

Alvarado¹,

McVey²,

Greenhalgh³

et al. 2021

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

Background Dashboards can support data-driven quality improvements in health care. They visualize data in ways intended to ease cognitive load and support data comprehension, but how they are best integrated into working practices needs further investigation. Objective This paper reports the findings of a realist evaluation of a web-based quality dashboard (QualDash) developed to support the use of national audit data in quality improvement. Methods QualDash was co-designed with data users and installed in 8 clinical services (3 pediatric intensive care units and 5 cardiology services) across 5 health care organizations (sites A-E) in England between July and December 2019. Champions were identified to support adoption. Data to evaluate QualDash were collected between July 2019 and August 2021 and consisted of 148.5 hours of observations including hospital wards and clinical governance meetings, log files that captured the extent of use of QualDash over 12 months, and a questionnaire designed to assess the dashboard’s perceived usefulness and ease of use. Guided by the principles of realist evaluation, data were analyzed to understand how, why, and in what circumstances QualDash supported the use of national audit data in quality improvement. Results The observations revealed that variation across sites in the amount and type of resources available to support data use, alongside staff interactions with QualDash, shaped its use and impact. Sites resourced with skilled audit support staff and established reporting systems (sites A and C) continued to use existing processes to report data. A number of constraints influenced use of QualDash in these sites including that some dashboard metrics were not configured in line with user expectations and staff were not fully aware how QualDash could be used to facilitate their work. In less well-resourced services, QualDash automated parts of their reporting process, streamlining the work of audit support staff (site B), and, in some cases, highlighted issues with data completeness that the service worked to address (site E). Questionnaire responses received from 23 participants indicated that QualDash was perceived as useful and easy to use despite its variable use in practice. Conclusions Web-based dashboards have the potential to support data-driven improvement, providing access to visualizations that can help users address key questions about care quality. Findings from this study point to ways in which dashboard design might be improved to optimize use and impact in different contexts; this includes using data meaningful to stakeholders in the co-design process and actively engaging staff knowledgeable about current data use and routines in the scrutiny of the dashboard metrics and functions. In addition, consideration should be given to the processes of data collection and upload that underpin the quality of the data visualized and consequently its potential to stimulate quality improvement. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2019-033208

show abstract

“…A number of clinical dashboards have been developed to provide specific information for clinicians on the status of their patients, including blood pressure (Stinson et al, 2012 ), lab results (Batley et al, 2011 ), diabetes (Koopman et al, 2011 ), acute respiratory infections (Linder et al, 2010 ), and radiography data (Morgan et al, 2008 ). Although quality dashboards are already used within hospitals (Weggelaar-Jansen et al, 2018 ), few have been discussed in the academic literature; probably the most notable example is QualDash (Elshehaly et al, 2020 ).…”

Section: Related Workmentioning

confidence: 99%

Requirements for a Dashboard to Support Quality Improvement Teams in Pain Management

et al. 2021

View full text Add to dashboard Cite

Pain management is often considered lower priority than many other aspects of health management in hospitals. However, there is potential for Quality Improvement (QI) teams to improve pain management by visualising and exploring pain data sets. Although dashboards are already used by QI teams in hospitals, there is limited evidence of teams accessing visualisations to support their decision making. This study aims to identify the needs of the QI team in a UK Critical Care Unit (CCU) and develop dashboards that visualise longitudinal data on the efficacy of patient pain management to assist the team in making informed decisions to improve pain management within the CCU. This research is based on an analysis of transcripts of interviews with healthcare professionals with a variety of roles in the CCU and their evaluation of probes. We identified two key uses of pain data: direct patient care (focusing on individual patient data) and QI (aggregating data across the CCU and over time); in this paper, we focus on the QI role. We have identified how CCU staff currently interpret information and determine what supplementary information can better inform their decision making and support sensemaking. From these, a set of data visualisations has been proposed, for integration with the hospital electronic health record. These visualisations are being iteratively refined in collaboration with CCU staff and technical staff responsible for maintaining the electronic health record. The paper presents user requirements for QI in pain management and a set of visualisations, including the design rationale behind the various methods proposed for visualising and exploring pain data using dashboards.

show abstract

QualDash: Adaptable Generation of Visualisation Dashboards for Healthcare Quality Improvement

Abstract: Fig. 1. A dashboard with four dynamically generated QualCards (left) including one for the Mortality metric (a); and an expansion of the Mortality QualCard with categorical (b), quantitative (c) and temporal (d) subsidiary views, which are customisable via a popover (e).

Cited by 38 publications

References 44 publications

Quality of acute myocardial infarction care in England and Wales during the COVID-19 pandemic: linked nationwide cohort study

Quality of acute myocardial infarction care in England and Wales during the COVID-19 pandemic: linked nationwide cohort study

Analysis of a Web-Based Dashboard to Support the Use of National Audit Data in Quality Improvement: Realist Evaluation

Requirements for a Dashboard to Support Quality Improvement Teams in Pain Management

Contact Info

Product

Resources

About