TY - JOUR
T1 - Effect of a real-time pediatric ICU safety bundle dashboard on quality improvement measures
AU - Shaw, Susanna J.
AU - Jacobs, Brian
AU - Stockwell, David C.
AU - Futterman, Craig
AU - Spaeder, Michael C.
N1 - Publisher Copyright:
Copyright 2015 The Joint Commission.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2015/9
Y1 - 2015/9
N2 - Background: Patient daily goal sheets have been shown to improve compliance with hospital policies but might not represent the dynamic nature of care delivery in the pediatric ICU (PICU) setting. A study was conducted at Children's National Health System (Washington, DC) to determine the effect of a visible, unitwide, real-time dashboard on timeliness of compliance with quality and safety measures. Methods: An automated electronic health record (EHR) - querying tool was created to assess compliance with a PICU Safety Bundle. Querying of the EHR for compliance and updating of the dashboard automatically occurred every five minutes. A real-time visual display showed data on presence of consent for treatment, restraint orders, presence of urinary catheters, deep venous thrombosis (DVT) prophylaxis, Braden Q score, and medication reconciliation. Baseline com pliance and duration of noncompliance was established during three time periods: the first, before activation of the dashboard; the second, at one month following activation of the dashboard; and the third, at three months after activation. Results: A total of 450 patients were included in the analysis. Between the first and third time periods, the median time from PICU admission to obtaining treatment consent decreased by 49%, from 393 to 202 minutes (p = .05). The number of patients with urinary catheters in place > 96 hours decreased from 16 (32%) in Period 1 to 11 (19%) for Periods 2 and 3 combined (p = .01). Completion of medication reconciliation improved from 80% in the first time period to 93% and 92%, respectively, in the subsequent two periods (p = .002). There was no difference between the three periods in presence of restraint orders, DVT prophylaxis, or development or worsening of pressure ulcers. Conclusions: A unitwide dashboard can increase awareness for potential interventions, affecting patient safety in the PICU in a dynamic manner.
AB - Background: Patient daily goal sheets have been shown to improve compliance with hospital policies but might not represent the dynamic nature of care delivery in the pediatric ICU (PICU) setting. A study was conducted at Children's National Health System (Washington, DC) to determine the effect of a visible, unitwide, real-time dashboard on timeliness of compliance with quality and safety measures. Methods: An automated electronic health record (EHR) - querying tool was created to assess compliance with a PICU Safety Bundle. Querying of the EHR for compliance and updating of the dashboard automatically occurred every five minutes. A real-time visual display showed data on presence of consent for treatment, restraint orders, presence of urinary catheters, deep venous thrombosis (DVT) prophylaxis, Braden Q score, and medication reconciliation. Baseline com pliance and duration of noncompliance was established during three time periods: the first, before activation of the dashboard; the second, at one month following activation of the dashboard; and the third, at three months after activation. Results: A total of 450 patients were included in the analysis. Between the first and third time periods, the median time from PICU admission to obtaining treatment consent decreased by 49%, from 393 to 202 minutes (p = .05). The number of patients with urinary catheters in place > 96 hours decreased from 16 (32%) in Period 1 to 11 (19%) for Periods 2 and 3 combined (p = .01). Completion of medication reconciliation improved from 80% in the first time period to 93% and 92%, respectively, in the subsequent two periods (p = .002). There was no difference between the three periods in presence of restraint orders, DVT prophylaxis, or development or worsening of pressure ulcers. Conclusions: A unitwide dashboard can increase awareness for potential interventions, affecting patient safety in the PICU in a dynamic manner.
UR - http://www.scopus.com/inward/record.url?scp=84946734230&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946734230&partnerID=8YFLogxK
U2 - 10.1016/S1553-7250(15)41053-0
DO - 10.1016/S1553-7250(15)41053-0
M3 - Article
C2 - 26289236
AN - SCOPUS:84946734230
SN - 1553-7250
VL - 41
SP - 414
EP - 420
JO - Joint Commission Journal on Quality and Patient Safety
JF - Joint Commission Journal on Quality and Patient Safety
IS - 9
ER -