Dashboards Help Nurses Respond to Quality Data

Quality improvement initiatives need the support of staff nurses to achieve their aims, but most staff nurses don't have time to read reports about how their individual unit is progressing. But they do have time to look at a dashboard that tells them at a glance whether their unit is meeting objectives or still has work to do.

Many organizations are finding that quality data dashboards can be an excellent way of communicating information throughout an organization and can be customized to drill down to individual unit data or show organizational objectives as a whole.

One organization that is using dashboards to communicate with staff nurses about nurse-sensitive quality indicators is Portsmouth-based Southern Ohio Medical Center.

SOMC color-codes the dashboard so that indicators are red or green, providing instant feedback on quality performance and nurses need only take a quick glance to see how their unit is doing. If objectives are being met, the indicator is green, but it is an eye-catching red if objectives are not being met.

"We can tell at a glance how we're doing," says Karen Marshall Thompson, RN, MS, CNS, director of home care services. "My boss, the CNO, can just glance at our dashboard and see how we're doing."

Each nursing unit at SOMC has a unit-specific dashboard, and all unit dashboards tie into the SOMC nursing dashboard. Some of the indicators roll into the SOMC organizational dashboard.

Some indicators are common across all unit dashboards, including pain management and patient satisfaction with the education they receive. Units also choose indicators that pertain to their unique patient population. For example, the ED monitors door-to-doctor and door-to-discharge times, which are crucial for keeping patient satisfaction scores high. The pediatric unit chose to include an indicator that measures the skills of nurses starting IVs—a crucial factor when trying to minimize pain and distress for the hospital's smallest patients.

Indicator objectives are chosen through methods such as examining national benchmarks or conducting a literature review to find best practices. "Sometimes, an indicator or process is so new that maybe we just compare our performance internally," says Thompson. "But ideally, we want to compare our performance to national benchmarks on any given indicator."

The indicators on the dashboards are periodically swapped for new ones. Indicators may be changed if the unit's staff members feel their performance is so consistently high on an objective that it is time to focus on a new objective or improvement opportunity. Or they may add a new indicator based on a new National Patient Safety Goal or innovation in nursing science.

The units try to not focus on too many issues at once. "We don't want to drown in data," notes Thompson. "We want it to be meaningful and focused and move the nursing unit and the organization in the direction of our strategic values."

If a unit's indicator had been green and turns to red or the team notices a drop-off in performance, staff members immediately initiate a rapid cycle action plan, which generally involves developing a 90-day goal of focusing on the issue and raising performance for the goal.

The team will brainstorm how to improve performance and will look to nursing literature and research to find best practices about how to reach the goals.

Thompson says the dashboards are an extremely effective tool for the organization. "It just kind of gets everyone pulling in the same direction," she says. Ultimately, the dashboards are also a matter of pride for each unit, which uses the dashboards to measure their performance.