Clinical Operations Dashboard
Bed management in the medical/surgical units is a critical issue,
driving a hospital's ability to accept new admissions. Without effective
bed management, our hospitals were sometimes forced to send potential
admissions elsewhere, losing the revenue from that admission and
potentially future admissions. We needed real-time data about the
capacity of all inpatient units, as well as some indication of expected
demand from the emergency departments or operating rooms.
At the time, we were just beginning to build a data
warehouse, and didn't have anything approaching real-time data.
Bill figured out how to grab up-to-the-minute data from our Meditech
system about inpatient bed status, as well as surgical day care
and emergency department admissions, discharges and transfers (ADT).
An automated process runs these reports continuously, round-the-clock,
every 10-15 minutes.
Working with physician and nursing leaders, we designed a dashboard
to display the current bed capacity for each hospital, with the
ability to drill down to the individual bed (shown below).
status of each hospital and each service within each hospital is
displayed graphically, color-coded as explained in the "mouse-over"
info button (shown below).
department status is also color-coded, as explained in the "mouse-over"
info button (shown below).
user can click on any button for a hospital or a service at a hospital.
Depending on which button is selected, the relevant inpatient units
are listed, color-coded by status and showing the available beds
for each (shown below). In addition, there are three tools to help
try to project bed demand for the remainder of the day:
admissions (input directly by admitting department staff based
on their knowledge of pending admissions)
admits (mean number of patients admitted on this day of the week
during the past six weeks, with one standard deviation [i.e.,
schedule (pulled directly from the PICIS operating room system
one of the clinical units, in this case the medical/surgical unit
listed above, displays the summary for that unit (shown below).
Physical beds are pulled directly from the Meditech system, and
may be fewer than the number of beds for which the unit is licensed.
for each data element are displayed in the "mouse-over"
for the info button by the unit's name (shown below).
the name of the inpatient unit displays the final drill-down level
for that unit. For each physical bed in the unit, the inpatient
service, length of stay (LOS) and gender of the current patient
are displayed (shown below).
The other part of the dashboard attempts to show basic information
about the status of each ED (shown below).
every tool is a hit. The Clinical operations dashboard was designed
per customer specifications to meet a perceived need, and provides
timely data that senior managers believed were critical for effective
management. However, front-line clinical managers never incorporated
the dashboard into their daily workflow, and the dashboard does
not get enough use to justify its development effort, for reasons
that are still not entirely clear.
is impossible to know in advance whether a specific application
will be a hit. Some applications have enthusiastic business sponsors
but a low level of usage. Other applications have no specific
business sponsor but have a high adoption rate and provide huge
if a specific application (such as this dashboard) does not achieve
its full potential, the automation and/or data developed for the
application can often be re-purposed for other applications, providing
a net benefit to the organization which is much greater than the
expected impact from the original application.
Posted 27 April 2008