Leveraging Data to Drive Quality Patient Care: The Value of a Unit-Specific Nursing Performance Dashboard

Purpose:

Performance data can be used to monitor and guide interventions aimed at improving the quality and safety of patient care.[1-4] Nursing plays an important role in quality management and performance improvement at the clinical level due to their interactions with patients and at an operational level nurse leaders have a key role in informing resource allocation and patient safety monitoring.[1,3,4] To use performance data effectively, nurses need to understand how to interpret and utilize data in meaningful ways to guide practice.Unless clinical nurses have knowledge about performance improvement measures, exposure to data reporting mechanisms, and shared accountability for quality, it may be difficult for them to participate in data-driven care.[1] One mechanism to provide feedback on patient outcomes, experiences, and processes of care is the use of dashboards. In this context, one hospital developed a unit specific dashboard aligned with the implementation of the Registered Nurses Association of Ontario’s Best Practice Guidelines. A study was undertaken to explore the perceptions and experiences of front-line nurses and managers associated with implementation of a unit-level dashboard.

Methods:

 A qualitative study was undertaken to explore the perceptions and experiences of front-line nurses and managers associated with the implementation of a unit-level dashboard, referred to as the CUE dashboard. The CUE dashboard initiative was implemented throughout a large, urban teaching hospital in Toronto, Ontario, Canada and involved six hospital units (outpatient mobility, emergency department, general internal medicine, general surgery, cardiac intensive care, and respirology). Data was analyzed using a directed content analysis approach.

Results:

A total of 61 interviews (56 front-line nurses and 5 unit managers) were conducted from the following clinical units: general internal medicine (n = 12); general surgery (n =11); respirology (n =10); out-patient mobility (n = 5); emergency (n = 12); and coronary care unit (n=6). Key themes emergedaround the enablers and barriers associated with implementation that included learning in a supportive work environment and finding times amidst clinical care priorities.

Conclusion:

The study findings highlight how front-line nurses and managers viewed implementation of a unit-specific dashboard. This study also provided insight into the experiences nurses and managers had during this process as well as key recommendations on how it could be better utilized.  Based on these results, nurse leaders may consider investing in the use of dashboards as a quality improvement strategy, or may use study findings to optimize the use of performance data by using dashboards in their organizations.