Purpose: Our goal was to build a dashboard that provides real-time decision support by consolidating and displaying data that are otherwise isolated within disciplines and different areas of the EHR in order to promote interdisciplinary communication about patient safety, and to identify, manage, and reduce preventable patient harms.
Description: We used an iterative participatory design approach to engage healthcare providers in developing a web-based patient safety dashboard. We held focus groups and observed workflows to capture initial and subsequent requirements of design, content, and functionality. Over a 16-month period in collaboration with human factors engineers and clinical stakeholders, the dashboard was designed, developed, refined, and made accessible to care team members within the vendor EHR for use during bedside rounds. The dashboard displays the status of 13 patient safety domains: code status documentation, glucose control, nutrition, bowel regimen, VTE prophylaxis, pain, antibiotic stewardship, pressure ulcers, delirium, fall risk, vascular access, Foley catheter use, and telemetry. Users can access a unit view that has alert information for all patients on a care unit or a more detailed patient-specific view (Figure). The program retrieves clinical data via web services refreshed at 5-minute intervals. We tested the dashboard over a one-week pilot implementation period and administered a usability survey to the team members (n=6). Survey responses confirmed the perception that the tool is usable and useful (Table), and comments revealed differences in priorities by care team role and the importance of speed and workflow integration in development of clinical tools.
Conclusions: User-centered design and innovative integration of live EHR data resulted in a tool that is highly regarded and has the potential to improve patient safety. We hypothesize that this intervention will improve processes of care and patient outcomes, which is currently under evaluation.