Evolution of Dashboards and its Effectiveness in Performance Management and Efficient Utilization of Time and Energy

N. Gethsial Kiruba*

Executive – Quality and Training, Kauvery Hospitals, India

*Correspondence: Tel: +91 9791417858; gethsialkiruba@gmail.com

Abstract

A dashboard is an information management tool that tracks and simplifies complex data sets and leverages data visualizations, allowing the users to gain quick insight into dynamics of current performance. Dashboards are commonly used for business reviews in various sectors. In a single hospital all critical reports of patients are reviewed and analyzed every day. But for a health care organization which consists of more than 5 hospitals, review of the reports is difficult as well as time and energy consuming. Analysis of reports manually has several challenges especially uncertainty of the quality of the data collected. This article focuses on the evolution of dashboards in healthcare setup and its effectiveness in performance management and in efficient utilization of time and energy.

Keywords: Clinical Governance Office, Human Resources, Decision Support System, Key Performance Indicators, Managing Director, Group Medical Director

Background Business dashboards emerged into existence four decades back.

In the early 1970s businesses were using decision support system (DSS) to perform their business tasks and this was comparable to the automobile industry where dashboards provided information on the status of critical functions like gasoline and oil levels, speed, engine temperature etc to the driver. Technology revolutionized this display and digital dashboards came into existence. Air crafts went on to ‘Glass Cockpits’ that displayed all information vital for flight. Dashboards continued to be developed and used in business reviews and were adopted by analytics professionals and managers of global organizations [1].

Kauvery Hospitals are a group of hospitals that has a strong presence in five cities of Tamil Nadu, and now also at Bangalore in Karnataka. The group now has seven hospitals and a bed capacity of 1200, offering multi-specialty healthcare services of global standards and treating 5,00,000 outpatients and 50,000 inpatients every year.

Clinical Governance emerged in Kauvery during the year 2017 with a futuristic approach to monitor and improve the patient care provided in the hospitals with highest quality and to provide absolute patient delight. Clinical Governance is “A frame work through which health care organization is accountable for continual improvement of quality and for safeguarding high standards of care by creating an environment for clinical care excellence”. Thereby, Kauvery assures “Delivery of safe and quality care for right patient on the right time”. Clinical Governance has three major goals: Safety of care, Appropriateness, Engagement and Partnership.The focus of the Clinical Governance is to have in place a comprehensive and competent monitoring system pan-Kauvery to monitor, review and respond to all critical alert reports and to strive for absolute patient safety and satisfaction.

Folk tales have told us about the five blind men, who had never come across an elephant in their lives, attempting to describe it by touching various parts of its body as snake, tree, rope etc. Hospitals are also giant organisms, with its various parts carrying out different functions. Hospital groups are even more complex. Analysis of clinical reports generated at a single hospital may not meet corporate objectives who wish to study pan-group performance as health care strives to achieve uniform standards across a group (Fig. 1).

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Fig 1. “The Blind men and the Elephant”.

But while analyzing at the group level, it can be challenging. To generate 12 key reports at the group level, 84 reports need to be downloaded from the hospital software every day which consumes lot of time and energy of the staff.

The numbers and sectors that are involved in a large hospital system are large:

7500 registrations

28000 out-patients

2500 in-patients

3500 employees

Clinical transactions

Operational transactions

Various audits

Millions of purchases

Comprehensive housekeeping

Complete maintenance

Enormous transport requirements

With all these commitments, there is never enough time for data analysis, data documentation or data validation. The idea of dashboards emerged out of this.

Kauvery Hospital developed Clinical Dashboard to begin with and named it as Chief Governance Officer (CGO) Dashboard. This information management tool visually tracked, analyzed and displayed key performance indicators (KPI), metrics and key data points that helped monitor the health of the business, a particular department or a specific process.

Dashboards in healthcare setting – What is a clinical dashboard?

Clinical dashboard in Kauvery is an information management tool that that tracks, analyzes and displays key performance indicators related to health care to monitor thepatient safety, quality of care and to attain patient delight (Fig. 2).

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Fig. 2. Clinical dashboard.

Objectives of clinical dashboard

  1. To give critical alerts on clinical parameters
  2. To find out any deviations in the patient safety parameters
  3. To review the occupancy, discharge, total no of surgeries etc on daily basis.
  4. To monitor the quality in nursing care and to analyze deviation if present

Components of dashboard

  1. Data sources: Data is received from HMS platform used in the hospitals by the nurses to inputpatient related
  2. Filters: Filters are text strings that are used to specify a subset of the data items in a database. They work on a set of comparisons that must be true in order for a data item to be accepted hence it filters irrelevant data and the rest of the data is projected on the dashboard.
  3. KPIs: Key performance indicators are the metrics most important to users. These are represented in dashboards either as such or as a part of tables. Common KPIs areAMA (discharge against medical advice), deaths, incidents, pressure injury etc.

Group level dashboards

1. Managing Director dashboard (Fig. 3)

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Fig. 3. MD dashboard

2. Group Medical Director dashboard (Fig. 4)

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Fig. 4. GMD dashboard

3. Clinical Governance Officer dashboard (Fig. 5)

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Fig. 5. CGO dashboard

4. HR dashboard (Fig. 6)

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Fig. 6. HR dashboard

5. Finance dashboard (Fig. 7)

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Fig. 7. Finance dashboard

6. MRD dashboard (Fig. 8)

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Fig. 8. MRD dashboard

Unit dashboards

1. Executive Director dashboard (Fig. 9)

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Fig. 9. ED dashboard

2. Medical Admin dashboard (Fig. 10)

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Fig. 10. Medical Admin dashboard

3. Operations Manager dashboard (Fig. 11)

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Fig. 11. Operation Manager dashboard

Recently, we have added COVID Dashboard, as a requirement of handling the pandemic situation (Fig. 12)

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Fig. 12. COVID Dashboard and admission tracker

Healthcare dashboards best practices followed at Kauvery

  1. Ensure users at each phase of development: Users were involved at every phase of development of each dashboards
  2. Define dashboards objectives: Dashboards objectives were defined before creating a new dashboard and its future plans were also defined.
  3. Customize views: The views of the dashboards were defined as per its needs and plans were there to put even as trend and bar graphs too.
  4. Emphasize data in order of importance: Data been projected in the dashboards are in the as per priority and need
  5. Use filters: Filters were used to project only the data of significant
  6. Ensure accuracy: Accuracy of the data were ensured while the dashboards were in the trial run period itself.
  7. Allow users to drill down: Users are allowed to deep dive in each data through the HMS portal for further details.
  8. Minimize use of colors: Colors were minimized to prevent deviation from fulfilling the purpose of the data.

Benefits of dashboards

Hospitals need to make informed decisions quickly. That’s where healthcare dashboards help. In addition, they integrate manpower information across the enterprise to improve workflow management across all hospitals. The benefits of healthcare dashboards are summarized below (Fig. 13).

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Fig. 13. Benefits of dashboards

Results

Better decision making

The biggest benefit of a dashboard is better decision-making. It allows users to look at summaries of aggregated data to make informed clinical decisions or others as per its concern. Not only is data easier to consume, but it can be analyzed faster.

Save time and minimizes errors

The Clinical and other dashboards save users time because they aggregate data from multiple sources and reveal the most important KPIs. Without dashboards, we need to manually compile data from multiple sources and aggregate the data by ourselves and that too for seven hospitals it takes enormous time to do it. The manual approach requires more resources than an automated dashboard and increases the chance of human error too. Automation frees valuable time to perform more detailed analyses.

Improved goal-setting

Dashboards helps us to make more data-driven decisions with goal-setting because the right data can be delivered at the right time. This leads to more accurate benchmarks and actionable goals at every level of our organization. With new information updated from the dashboards goals and expectations can be adjusted as needed.

More flexibility

Modern dashboards include device flexibility, which allows users to access and interact with dashboards anywhere, on any device if the access is been provided by the IT as data security is also a major concern for our healthcare organization. This provides anyone in the organization with easy access to insights from aggregated data without the need to find them manually. This has the added benefit of creating an improved customer experience.

Shared insights

Full implementation of an analytics platform allows people throughout an enterprise to gain visibility into KPIs in each department. For example, a HR department at our organization wants to understand how employee retention in each department compares to the overall organization to determine if their management methods are effective from an employee satisfaction standpoint.

Improves performance

Comparing the KPIs between the hospitals not only help them to improve their goal setting but also make the employees to work towards their goal and to achieve it in a way better than the previous one comparatively.

Conclusion

Automation of dashboards in our organization enables us to continuously focus in eliminating non value added activities in the process of collecting and consolidating the data manually and to focus on value added activities like improved goal setting and to achieve the goal and also to concentrate more on bringing patient delight and employee satisfaction.

Acknowledgement

Herewith, we thank our Managing Director and the entire technology team of our organization for their continuous support in creating and implementing these dashboards across the organization.

References

  1. Business Intelligence Dashboards Guide book – Best Practices to understand the concept of dashboards and its significant uses; https://www.datapine.com/articles/bi-dashboard-best-practices

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