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Dashboards in Healthcare
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In the same way that the 'Service due' indicator in your car is designed to help keep you on the road and out of the garage, an organisational dashboard should help senior managers ensure the effective and efficient operation of their business, whatever its nature.
Dashboards are increasingly being heralded as an important tool to enhance management effectiveness in healthcare organisations in the USA; and Oakleigh Consulting's Peter Rogers believes they are a development which British healthcare managers will also find invaluable.
A Dashboard is a succinct, easily readable, usually graphical display of the key performance indicators a management team wants to monitor regularly. It provides a single view of information from across an organisation and presents it in a readily accessible way.
In a UK healthcare context a dashboard might include measures of financial performance, national targets, quality of care, clinical governance (including patient experience and safety) and human resource performance.
7 Benefits of Dashboards for Health
1. Graphical representation make strategic data easy to understand
2. Make it possible to quickly assess an organisation's overall status
3. Concise presentation enables quick reviewing of KPIs and highlighting problems areas
4. Facilitates decision making by comparing the organisations performance with predetermined benchmarks and standards
5. The consolidated format is linked to more detailed data which supports in depth consideration of issues when necessary
6. Focuses users on information about the indicators judged as the most important to the organization
7. Helps in gaining financial support for current and future improvement efforts by highlighting the benefits of change initiatives
Visual Impact of Dashboards
What distinguishes dashboards from other business information systems is the graphical display of information. A variety of images, including gauges, run and pie charts and bar graphs are typically used. The use of colour coded traffic lights are also popular to distinguish between performance that is and is not on track.
Dashboards Facilitate Decision-Making
A recent US survey found that executives spent the equivalent of at least one day a week gathering the information they needed to make decisions. They also frequently relied on summarised briefings provided by their staff which can be subject to a variety of unconscious and conscious influences such as the desire to suppress or delay 'bad news'. In addition, the actual information collected may be focusing on the wrong metrics.
The use of dashboards can help to resolve these issues by ensuring that the information necessary to oversee the efficient running of the organisation is readily available and in a form that can be rapidly assimilated and acted upon.
Drilling Down
Although the whole purpose of a dashboard is to provide a high-level overview of organisational performance, people both inside and outside an organisation will inevitably want more detail about specific indicators. Whether electronic or paper based, the dashboard should permit a user to access more detailed information about any of the headline key performance measures.
At the Middlesex Health System in Middletown Connecticut this next level of information includes a definition of the measure along with an explanation of how the associated target was set and where necessary, how the organisations performance is calculated. Colour coded displays show performance in the current reporting period, the year-to-date and where appropriate, for the previous year.
The drill-down feature can be further developed to provide tiers of performance data for each level of the organisation such as directorate or unit and even to the level of individual clinicians if required.
Flexibility of Dashboards for Health
Although some health sector indicators like financial performance, waiting times and adherence to NICE guidelines are indispensable perennials in judging organisational performance, an additional benefit of dashboards is their flexibility.
Dashboards can be adapted to include the monitoring of specific time limited priorities. For example, an organisation that has experienced a maternal or perinatal infant death in which the level of input from a consultant obstetrician or a senior midwife has been identified as a cause for concern may well wish to track the vacancy rates and turnover of staff in these roles through its dashboard. Once managers have met the recruitment and retention challenges and staffing establishment has stabilised the indictors would be removed.
Choose Your Dashboard Indicators with Care
Poorly chosen indicators can be worse than having none at all. Bad metrics promote dysfunctional behaviour that cause confusion and paradoxically may result in a worse patient experience. For example, the target for patients with non-urgent conditions is to be seen by a GP within 48 hours.
In practice this target measures the wrong thing as the clock does not start until the patient is given an appointment, which in some cases may be several days after the request. The metric that should be on the PCT's dashboard is the time between the patient's request for an appointment and seeing the doctor.
7 Success Factors for Dashboard Metrics
1. Involve as wide a group of stakeholders as possible from the very start of the development process, but maintain a clear sense of the organisations strategic objectives.
2. Use SMART1 criteria for evaluating each metric. If it doesn't meet all five criteria, reject it
3. Assign an owner (an individual rather than a team or department) for each metric
4. Specify a target or expected range of performance for each metric
5. Validate each metric to ensure it produces the required results
6. Periodically review all metrics to ensure they still reflect the organisations priorities
7. When selecting dashboard metrics, remember less is more
After Symons & Brown
In environments such as health care which are frequently characterised as data rich and information poor, dashboards offer staff at every level the focused and concise information they need to ensure that their contribution to service delivery and improvement has a positive impact on the overall performance of their organisation.
If you have any questions about the subjects covered in this white paper or you would like to find out more about how Oakleigh Consulting could help your organisation, please contact us on 0161 835 4100 or email us.
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