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Development and Implementation of a Real-time Bundle-adherence Dashboard for Central Line-associated Bloodstream
Augustine Chemparathy1, Martin G Seneviratne2, Andrew Ward3
1Department of Management Science and Engineering, Stanford University, Stanford, Calif.
Insights
A new electronic dashboard improved adherence to central line-associated bloodstream infection (CLABSI) prevention bundles in pediatric patients. This tool enhanced data transparency and accountability, leading to significant increases in infection control practices.
Area of Science:
- Healthcare Quality Improvement
- Infection Prevention and Control
- Health Informatics
Background:
- Central line-associated bloodstream infections (CLABSIs) are a leading hospital-acquired infection in pediatric care.
- High adherence to CLABSI prevention bundles is crucial for mitigating these infections.
- The institution previously lacked a systematic method for hospital-wide bundle adherence monitoring.
Purpose of the Study:
- To develop and implement an electronic dashboard for real-time monitoring of CLABSI bundle adherence.
- To improve data transparency and facilitate accountability initiatives for infection control.
Main Methods:
- Stakeholder interviews and data analysis identified areas for improvement.
- A data pipeline was established to feed adherence data into an electronic health record dashboard.
- The dashboard visualized overall and element-specific bundle adherence across hospital units.
Main Results:
- Hospital-wide all-element adherence increased from 25% to 44% between September 2018 and December 2019.
- Average adherence to individual bundle elements also showed improvement during the study period.
- The dashboard facilitated unit-level accountability initiatives through data presentation at improvement meetings.
Conclusions:
- Deployment of a real-time electronic dashboard significantly increased CLABSI bundle adherence.
- The dashboard enabled effective population-level surveillance and informed targeted infection control strategies.
- Electronic dashboards are valuable tools for enhancing infectious disease control through data transparency.
Introduction:
Central line-associated bloodstream infections (CLABSIs) are the most common hospital-acquired infection in pediatric patients. High adherence to the CLABSI bundle mitigates CLABSIs. At our institution, there did not exist a hospital-wide system to measure bundle-adherence. We developed an electronic dashboard to monitor CLABSI bundle-adherence across the hospital and in real time.
Methods:
Institutional stakeholders and areas of opportunity were identified through interviews and data analyses. We created a data pipeline to pull adherence data from twice-daily bundle checks and populate a dashboard in the electronic health record. The dashboard was developed to allow visualization of overall and individual element bundle-adherence across units. Monthly dashboard accesses and element-level bundle-adherence were recorded, and the nursing staff's feedback about the dashboard was obtained.
Results:
Following deployment in September 2018, the dashboard was primarily accessed by quality improvement, clinical effectiveness and analytics, and infection prevention and control. Quality improvement and infection prevention and control specialists presented dashboard data at improvement meetings to inform unit-level accountability initiatives. All-element adherence across the hospital increased from 25% in September 2018 to 44% in December 2019, and average adherence to each bundle element increased between 2018 and 2019.
Conclusions:
CLABSI bundle-adherence, overall and by element, increased across the hospital following the deployment of a real-time electronic data dashboard. The dashboard enabled population-level surveillance of CLABSI bundle-adherence that informed bundle accountability initiatives. Data transparency enabled by electronic dashboards promises to be a useful tool for infectious disease control.
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