Process Improvement Dashboard
Process improvements relate to positive changes in the efficiency, efficacy or effectiveness of clinical care and management. Efficiency is an early priority, particularly best use of scarce health care facility resources. Improved discharge efficiency, for example, helps patients get to intended discharge destinations, with appropriate supports, once discharge decisions have been made. The Process Improvement Dashboard is one of interlinked minimum use, meaningful use, process improvement and outcomes improvement feedback mechanisms; important for guaging the impact of informational interventions targetting health process improvement. The Dashboard, in turn, becomes part of the informational intervention supporting adherance to process improvement norms:
Feedback about trends in norms compliance can help clinicians identify potential workflow challenges while also helping to find ways to improve health processes.
Finding Norms Dashboards
Workflow-Embedded Access
The easiest way to get to meaningful use dashboards is by clicking on (selecting) the target icon/symbol appearing in many discharge planning workflows and tools. This opens the dashboard activity with a relevant dashboard pre-selected. The norms dashboards all contain a block of menu-links that facilitate jumping from one dashboard, such as meaningful use personal, to another dashboard, such as meaningful use group.
Dashboards Activity
Norms metrics are gathered and displayed using "dashboards", available through the "My Dashboards" Hyperspace activity. This is, by default, one of the main start-up activities appearing among the tabs showing at the top of Hyperspace after login. The activity can also be launched from the Epic menu or by using global search and jumping to "My Dashboards".
Within the My Dashboards activity, select the down-arrow to the right of the currently displaying dashboard name, then use the search tool that appears with the keyword "norms" in order to find and open/run a norms dashboard.
Feedback for Individuals
Personal norms feedback metrics are made available to all Connect Care clinicians for individual feedback. The associated dashboard does not display group comparators, benchmarks with other organizations, or upper and lower bounds for acceptable compliance.
Feedback for Groups
Group norms feedback metrics provide anonymized group data and are provided to Connect Care and clinical oversight groups responsible for clinical information system training and use. Grouping at the level of facilities (e.g., hospital), units, services (admitting specialty) and primary provider teams may be possible.
Norms Categories and Links
Norms dashboards are divided into sections separating data for inpatient, outpatient and other contexts of care. One or more component boxes are found within a section, each focusing on a different norm. Clicking on a section title brings up additional information about the norm, why it matters and what can be done to improve compliance with the norm. Clicking on any information icon (i) likewise gives access to more detailed information about the provenance of the displayed metric.
Compliance Metrics
Measures of Connect Care behaviours that may correlate with process improvements are selected for presentation in the dashboard. These are usually expressed as a ratio (percentage) of patient encounters (e.g., admissions, outpatient visits) associated with the current user (e.g., as attending prescriber) or group where an indicator of possible norms compliance is detected (e.g., discharge order was actioned before 11:00).
Note the information icon (i) that appears when hovering over a metric row. Selecting this icon activates a pop-up description of the metric, together with a link to a more detailed definition that includes details about how the metric was validated and what might limit its interpretation.
Metric Display
Meaningful use metrics are displayed in tabular format (row of monthly averages) by default. Graphical displays can be substituted by clicking the rightmost three-vertical-dot icon and then selecting "Show Graph" from the pop-up menu. Reverting to a tabular display uses the same menu.
Metric Data
Individual metrics may have one or more data points (e.g., measures for a series of months). Some data points may appear to be outliers or otherwise not reflecting a user's sense of personal compliance with that minimum use norm. A number of actions can be taken to dig deeper into the data behind a metric, and so understand why the measure and the target behaviour may be out of sync:
Data Hover
Data points usually display as percentages. Hovering over a data point activates a small pop-up display of the ratio informing the percentage. By this means, one can quickly recognize when small denominators (e.g., only a few patients seen in a particular metric period) make the percentage very sensitive to small changes in numerators.Data Pick List
Hovering over a data point exposes a small down-arrow icon that can be selected to reveal a pop-up menu of options for additional actions that can be taken with the data point. The most useful of these will be an option entitled "View ___ Details"; selecting this option will cause a report to be run that will list all the information events that informed the metric. By this means, for example, one can drill down to individual charts, encounters and actions (e.g., orders) to better understand how a data point came to display as shown in the dashboard. This action is most useful when a data point seems off-kilter. There is usually an explanation discerned from the supporting data.
Dashboard Feedback
Many factors can reflect how well process metrics reflect actual clinical activities. Associated calculations have been carefully reviewed and revised to better suit Alberta work patterns. However, review by a broader range of prescribers in a wide range of clinical contexts will reveal anomalies not previously considered. Please use the "Feedback" link at the bottom right of the dashboard - this will activate an online survey where problems can be reported and suggestions recorded.