The Creation of a Pediatric Hospitalist Medicine Dashboard Across a Four Hospital Network: Performance Assessment for Improvement

Background:

The Pediatric Hospital Medicine Strategic Planning Roundtable mandated the creation of a dashboard to enable programs to monitor their clinical practice and make continuous improvements. A subcommittee then proposed the specific metrics to include. To date, however, no programs report implementing a dashboard that includes the measures of quality, productivity and sustainability that were identified by this subcommittee.

Purpose:

• 1. Develop and implement a dashboard to demonstrate productivity, clinical quality, group sustainability and non‐clinical value added for an academic division of PHM over time and across four inpatient sites.
• 2. Identify opportunities for improvement and inform programmatic decision making.

Description:

Based on the national PHM Dashboard Committee recommendations a sample dashboard was proposed and reviewed by multiple members of the division. We determined the feasibility of collecting these metrics by assessing what data were available from administrative sources and modified them to enable collection of comparable data from all four hospitals.

We collected quarterly data from October 2011 to September 2013 for 9 metrics related to productivity (100%; N=288), 18 clinical quality metrics (76%; N=576) and 8 group sustainability metrics (100%; N=256). Examples of these metrics include number of discharges, percent of newborn discharge orders by 10 a.m., and percent staffed at each site, respectively. Eighteen non‐clinical value added data metrics such as committee participation and grants awarded were collected annually from 68% of faculty. We found comparable metrics across all sites for productivity, group sustainability and non‐clinical value added domains; however, only 72% of the quality metrics are tracked in a comparable fashion across sites. After sharing this data with the division, there is an increase in participation in hospital committees from 17 hospitalists to 21 and an improvement in the percent of discharges from the nursery by 10 a.m. from 60% to 90%.

Conclusions:

PHM Dashboards have the potential guide program development, mobilize faculty to improve care and demonstrate the value of the program to stakeholders. Reliance on administrative data limits the metrics that can be tracked. Future efforts will expand the quality metrics tracked and reduce the manual effort involved in assembling the dashboard.