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Timely Data for Targeted Quality Improvement Interventions: Use of a Visual Analytics Dashboard for Bronchiolitis.

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A quality improvement dashboard supported interventions for bronchiolitis care, but direct impact on outcomes was not proven. Further research is needed to understand low clinician engagement with the dashboard.

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Area of Science:

  • Pediatric Healthcare Quality Improvement
  • Clinical Informatics
  • Respiratory Illness Management

Background:

  • Standard data collection methods can delay crucial quality improvement (QI) interventions for conditions like bronchiolitis, a frequent cause of pediatric hospitalization.
  • A multifaceted QI initiative was implemented to reduce the use of chest radiographs, bronchodilators, antibiotics, steroids, and viral testing in pediatric bronchiolitis cases.

Purpose of the Study:

  • To describe the implementation and utilization of a dashboard within a QI initiative for bronchiolitis management.
  • To assess the dashboard's role in supporting a multifaceted quality improvement strategy aimed at optimizing bronchiolitis care.

Main Methods:

  • A multidisciplinary team developed a clinical guideline and order set for bronchiolitis.
  • A vendor's dashboard was modified to display real-time data on guideline metrics for patients aged 2 months to 2 years.
  • Data were collected from October 2014 to April 2018, with outcomes including dashboard functionality, clinician login rates, and use of guideline-recommended care.

Main Results:

  • The dashboard was implemented in August 2016, consolidating data within 2-4 days post-discharge.
  • Only 35% of emergency department clinicians logged into the dashboard; leaders used it for targeted interventions.
  • While most outcome metrics improved, direct causation by the dashboard was not evident, though emergency department balancing measures decreased.

Conclusions:

  • The dashboard served as a tool for leaders to target QI interventions in bronchiolitis care.
  • Despite its use by leadership, the dashboard did not demonstrate a direct impact on the observed improvements in care metrics.
  • Future research should investigate the reasons behind the low rate of individual clinician engagement with the dashboard.