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

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.