Good quality information is known to be a driver of performance among clinical teams and vital to ensuring the right services and best possible care is provided to patients.
A clinical dashboard is a visual display of such information developed to provide clinicians with relevant and timely access to the information they need to improve quality of patient care. The development of these dashboards was a key recommendation from both the next stage review and the Health Informatics Review of 2008.
Clinical dashboards offer many key features. They:
- provide better information for clinical teams, presented in an easy to understand format with high visual impact
- utilise multiple sources of existing data
- provide clinical information relevant across multidisciplinary teams
- provide information in “real time” with no delay for data cleansing
- allow configuration to local requirements and comparison against national data sets (where these are available)
Piloting the dashboard
The clinical dashboard pilot has successfully implemented 24 dashboards across the country. These embrace the full range of healthcare settings, including: primary care, mental health, ambulance trusts and multiple secondary care specialties.
There is a general enthusiasm for this technology among clinicians. Of the clinicians involved in the pilots, ninety five percent agreed that information in this format enables improved decision making and service provision.
The best results are found when dashboards support specific local improvement activities. However they can also support statutory reporting requirements, professional body requirements or national guidelines and several dashboards within the pilot display national measures, or those from professional organisations.
The pilot has shown that unrelated clinical teams are often interested in similar measures and the work is feeding into the Department of Health’s Measuring for Quality Improvement project, developing metric governance guidelines and channels for the development of meaningful clinical indicators.
The current financial challenges facing the NHS should not be underestimated. At the same time, the importance of maintaining and improving the general quality of clinical care remains paramount. Striking this balance lies at the heart of the quality and productivity challenge facing NHS trusts. Specifically it requires the ability to clearly demonstrate local improvements, best achieved through engagement and leadership with clinicians themselves.
Clinical dashboards act as enablers to improve clinical quality and productivity. They provide a visual display of information, typically taken from a range of existing systems (sometimes even crossing organisational boundaries), to show and track local performance.
In addition they can enable clinicians to “drill down” and generate customised reports on underlying data. This allows clinical teams to lead local clinical governance cycles more effectively and provides practical opportunities to identify and then maintain effective change.
When it comes to demonstrating local quality, clinically relevant and clinically chosen measures should be used wherever possible. Clinical dashboards help draw out such measures before feeding information from local systems, for everyday use. Timely access to this information is vitally important to show which local interventions make a positive difference. The first step is often establishing current baseline levels, which can then shape and support the right service changes. This provides good foundations for robust, evidence-based local improvements in quality and productivity.
Bolton GPs improve performance through clinical dashboards
Bolton PCT have been involved in the clinical dashboards programme since 2008 and are now working towards implementing clinical dashboards in all 56 GP practices across the trust.
The clinical dashboards being implemented at Bolton use two different sets of metrics which display timely and relevant clinical information in a dashboard format and aim to improve the quality of patient data available to NHS staff, allowing them to make informed decisions regarding patient care.
Clinical Lead at NHS Bolton, Anne Talbot, explained: “At Bolton, we have in effect two dashboards: one set looks at a broad range of metrics in relation to practice performance, which allows GPs and practice staff an insight into the quality of care they deliver so that they can identify what they are doing well and any areas for improvement.
“The second set of metrics relates to urgent care and provides a real-time link from acute health settings into GP practices. The urgent care metrics also link to the practice disease registers and allow GPs and other practice health professionals to see which of their patients are seeking urgent or out-of-hours medical care from other services, such as A&E or the local walk-in centre. This approach helps to more pro-actively manage and better co-ordinate patients’ healthcare, especially for our most vulnerable patients and those with long-term conditions.”
Dashboards bring multiple benefits
Over the past year, clinical dashboards have evolved and feedback shows that the dashboards technology is allowing clinicians to manage their case loads more effectively, increase productivity, manage and monitor performance and streamline data collection processes.
Ms Talbot said, “As a practising clinician myself, clinical dashboards have allowed me access to a wealth of data relating to my practice, on my desktop. This data allows me to compare my own practice to my peer practices in Bolton and allows me to view changes in performance over time.
“Another benefit of the clinical dashboards is that we are able to link up primary and acute care settings through the urgent care metrics. These metrics show which patients are accessing GP out of hours care, have attended A&E or have required hospital admission in real time, joining up data from different aspects of healthcare, giving a more rounded complete picture for each individual patient.”