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Published in: Journal of Clinical Monitoring and Computing 3/2021

01-05-2021 | Original Research

Development, implementation and preliminary evaluation of clinical dashboards in a department of anesthesia

Authors: Géry Laurent, Mouhamed D. Moussa, Cédric Cirenei, Benoît Tavernier, Romaric Marcilly, Antoine Lamer

Published in: Journal of Clinical Monitoring and Computing | Issue 3/2021

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Abstract

Clinical dashboards summarize indicators of high-volume patient data in a concise, user-friendly visual format. There are few studies of the use of dashboards to improve professional practice in anesthesiology. The objective of the present study was to describe the user-centered development, implementation and preliminary evaluation of clinical dashboards dealing with anesthesia unit management and quality assessment in a French university medical center. User needs and technical requirements were identified in end user interviews and then synthesized. Several representations were then developed (according to good visualization practice) and submitted to end users for appraisal. Lastly, dashboards were implemented and made accessible for everyday use via the medical center’s network. After a period of use, end user feedback on the dashboard platform was collected as a system usability score (range 0 to 100). Seventeen themes (corresponding to 29 questions and 42 indicators) were identified. After prioritization and feasibility assessment, 10 dashboards were ultimately implemented and deployed. The dashboards variously addressed the unit’s overall activity, compliance with guidelines on intraoperative hemodynamics, ventilation and monitoring, and documentation of the anesthesia procedure. The mean (standard deviation) system usability score was 82.6 (11.5), which corresponded to excellent usability. We developed clinical dashboards for a university medical center’s anesthesia units. The dashboards’ deployment was well received by the center’s anesthesiologists. The dashboards’ impact on activity and practice after several months of use will now have to be assessed.
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Literature
2.
go back to reference Wong PC, Thomas J. Visual analytics. IEEE Comput Graph Appl. 2004;24(5):20–1.PubMed Wong PC, Thomas J. Visual analytics. IEEE Comput Graph Appl. 2004;24(5):20–1.PubMed
3.
go back to reference Few S. Information dashboard design : the effective visual communication of data/S. Few. Cambridge: O’Reilly Media; 2006. Few S. Information dashboard design : the effective visual communication of data/S. Few. Cambridge: O’Reilly Media; 2006.
4.
go back to reference Vallurupalli V, Bose I. Business intelligence for performance measurement: a case based analysis. Decis Support Syst. 2018;111:72–85. Vallurupalli V, Bose I. Business intelligence for performance measurement: a case based analysis. Decis Support Syst. 2018;111:72–85.
5.
go back to reference Wilbanks BA, Langford PA. A review of dashboards for data analytics in nursing. Comput Inform Nurs. 2014;32(11):545–9.PubMed Wilbanks BA, Langford PA. A review of dashboards for data analytics in nursing. Comput Inform Nurs. 2014;32(11):545–9.PubMed
6.
go back to reference Daley K, Richardson J, James I, Chambers A, Corbett D. Clinical dashboard: use in older adult mental health wards. Psychiatrist. 2013;37(3):85–8. Daley K, Richardson J, James I, Chambers A, Corbett D. Clinical dashboard: use in older adult mental health wards. Psychiatrist. 2013;37(3):85–8.
7.
go back to reference Dowding D, Randell R, Gardner P, Fitzpatrick G, Dykes P, Favela J, et al. Dashboards for improving patient care: review of the literature. Int J Med Inf. 2015;84(2):87–100. Dowding D, Randell R, Gardner P, Fitzpatrick G, Dykes P, Favela J, et al. Dashboards for improving patient care: review of the literature. Int J Med Inf. 2015;84(2):87–100.
8.
go back to reference Karami M, Safdari R. From information management to information visualization: development of radiology dashboards. Appl Clin Inform. 2016;7(2):308–29.PubMedPubMedCentral Karami M, Safdari R. From information management to information visualization: development of radiology dashboards. Appl Clin Inform. 2016;7(2):308–29.PubMedPubMedCentral
9.
go back to reference Waitman LR, Phillips IE, McCoy AB, Danciu I, Halpenny RM, Nelsen CL, et al. Adopting real-time surveillance dashboards as a component of an enterprise wide medication safety strategy. Jt Comm J Qual Patient Saf. 2011;37(7):326–32.PubMed Waitman LR, Phillips IE, McCoy AB, Danciu I, Halpenny RM, Nelsen CL, et al. Adopting real-time surveillance dashboards as a component of an enterprise wide medication safety strategy. Jt Comm J Qual Patient Saf. 2011;37(7):326–32.PubMed
10.
go back to reference Bakos KK, Zimmermann D, Moriconi D. Implementing the clinical dashboard at VCUHS. In: NI 2012 11th international congress on nursing informatics, 23–27 June 2012, Montreal, Canada, 2012. Bakos KK, Zimmermann D, Moriconi D. Implementing the clinical dashboard at VCUHS. In: NI 2012 11th international congress on nursing informatics, 23–27 June 2012, Montreal, Canada, 2012.
11.
go back to reference Franklin A, Gantela S, Shifarraw S, Johnson TR, Robinson DJ, King BR, et al. Dashboard visualizations: supporting real-time throughput decision-making. J Biomed Inform. 2017;71:211–21.PubMed Franklin A, Gantela S, Shifarraw S, Johnson TR, Robinson DJ, King BR, et al. Dashboard visualizations: supporting real-time throughput decision-making. J Biomed Inform. 2017;71:211–21.PubMed
12.
go back to reference Yoo J, Jung KY, Kim T, Lee T, Hwang SY, Yoon H, et al. A real-time autonomous dashboard for the emergency department: 5-year case study. JMIR mHealth uHealth. 2018;6(11):e10666.PubMedPubMedCentral Yoo J, Jung KY, Kim T, Lee T, Hwang SY, Yoon H, et al. A real-time autonomous dashboard for the emergency department: 5-year case study. JMIR mHealth uHealth. 2018;6(11):e10666.PubMedPubMedCentral
13.
go back to reference Martin N, Bergs J, Eerdekens D, Depaire B, Verelst S. Developing an emergency department crowding dashboard: a design science approach. Int Emerg Nurs. 2018;39:68–766.PubMed Martin N, Bergs J, Eerdekens D, Depaire B, Verelst S. Developing an emergency department crowding dashboard: a design science approach. Int Emerg Nurs. 2018;39:68–766.PubMed
14.
go back to reference Zaydfudim V, Dossett LA, Starmer JM, Arbogast PG, Feurer ID, Ray WA, et al. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle. Arch Surg. 2009;144(7):656–62.PubMed Zaydfudim V, Dossett LA, Starmer JM, Arbogast PG, Feurer ID, Ray WA, et al. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-associated pneumonia with the ventilator bundle. Arch Surg. 2009;144(7):656–62.PubMed
15.
go back to reference Linder JA, Schnipper JL, Tsurikova R, Yu DT, Volk LA, Melnikas AJ, et al. Electronic health record feedback to improve antibiotic prescribing for acute respiratory infections. Am J Manag Care. 2010;12((Suppl HIT)):e311–e319319. Linder JA, Schnipper JL, Tsurikova R, Yu DT, Volk LA, Melnikas AJ, et al. Electronic health record feedback to improve antibiotic prescribing for acute respiratory infections. Am J Manag Care. 2010;12((Suppl HIT)):e311–e319319.
16.
go back to reference McLaughlin N, Afsar-manesh N, Ragland V, Buxey F, Martin NA. Tracking and sustaining improvement initiatives leveraging quality dashboards to lead change in a neurosurgical department. Neurosurgery. 2014;74(3):235–44.PubMed McLaughlin N, Afsar-manesh N, Ragland V, Buxey F, Martin NA. Tracking and sustaining improvement initiatives leveraging quality dashboards to lead change in a neurosurgical department. Neurosurgery. 2014;74(3):235–44.PubMed
17.
go back to reference Patel MS, Rathi B, Tashfeen K, Yarubi MA. Development and implementation of maternity dashboard in regional hospital for quality improvement at ground level: a pilot study. Oman Med J. 2019;34(3):194–9.PubMedPubMedCentral Patel MS, Rathi B, Tashfeen K, Yarubi MA. Development and implementation of maternity dashboard in regional hospital for quality improvement at ground level: a pilot study. Oman Med J. 2019;34(3):194–9.PubMedPubMedCentral
18.
go back to reference Morgan MB, Branstetter BF, Lionetti DM, Richardson JS, Chang PJ. The radiology digital dashboard: effects on report turnaround time. J Digit Imaging. 2008;21(1):50–8.PubMed Morgan MB, Branstetter BF, Lionetti DM, Richardson JS, Chang PJ. The radiology digital dashboard: effects on report turnaround time. J Digit Imaging. 2008;21(1):50–8.PubMed
19.
go back to reference Douglas JR, Ritter MJ. Implementation of an anesthesia information management system (AIMS). Ochsner J. 2011;11(2):102–14.PubMedPubMedCentral Douglas JR, Ritter MJ. Implementation of an anesthesia information management system (AIMS). Ochsner J. 2011;11(2):102–14.PubMedPubMedCentral
20.
go back to reference Simpao AF, Tan JM, Lingappan AM, Gálvez JA, Morgan SE, Krall MA. A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems. J Clin Monit Comput. 2017;31(5):885–94.PubMed Simpao AF, Tan JM, Lingappan AM, Gálvez JA, Morgan SE, Krall MA. A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems. J Clin Monit Comput. 2017;31(5):885–94.PubMed
21.
go back to reference Gálvez JA, Ahumada L, Simpao AF, Lin EE, Bonafide CP, Choudhry D, et al. Visual analytical tool for evaluation of 10-year perioperative transfusion practice at a children’s hospital. J Am Med Inform Assoc. 2014;21(3):529–34.PubMed Gálvez JA, Ahumada L, Simpao AF, Lin EE, Bonafide CP, Choudhry D, et al. Visual analytical tool for evaluation of 10-year perioperative transfusion practice at a children’s hospital. J Am Med Inform Assoc. 2014;21(3):529–34.PubMed
22.
go back to reference Pabalate J. The effect of electronic feedback on anesthesia providers’ timely preoperative antibiotic administration. Dissertation, p 91. Pabalate J. The effect of electronic feedback on anesthesia providers’ timely preoperative antibiotic administration. Dissertation, p 91.
23.
go back to reference Tremper KK, Mace JJ, Gombert JM, Tremper TT, Adams JF, Bagian JP. Design of a novel multifunction decision support display for anesthesia care: AlertWatch® OR. BMC Anesthesiol. 2018;18(1):16.PubMedPubMedCentral Tremper KK, Mace JJ, Gombert JM, Tremper TT, Adams JF, Bagian JP. Design of a novel multifunction decision support display for anesthesia care: AlertWatch® OR. BMC Anesthesiol. 2018;18(1):16.PubMedPubMedCentral
24.
go back to reference Nelson O, Sturgis B, Gilbert K, Henry E, Clegg K, Tan JM, et al. A visual analytics dashboard to summarize serial anesthesia records in pediatric radiation treatment. Appl Clin Inform. 2019;10(4):563–9.PubMedPubMedCentral Nelson O, Sturgis B, Gilbert K, Henry E, Clegg K, Tan JM, et al. A visual analytics dashboard to summarize serial anesthesia records in pediatric radiation treatment. Appl Clin Inform. 2019;10(4):563–9.PubMedPubMedCentral
25.
go back to reference Dolan JE, Lonsdale H, Ahumada LM, Patel A, Samuel J, Jalali A, et al. Quality initiative using theory of change and visual analytics to improve controlled substance documentation discrepancies in the operating room. Appl Clin Inform. 2019;10(3):543–51.PubMedPubMedCentral Dolan JE, Lonsdale H, Ahumada LM, Patel A, Samuel J, Jalali A, et al. Quality initiative using theory of change and visual analytics to improve controlled substance documentation discrepancies in the operating room. Appl Clin Inform. 2019;10(3):543–51.PubMedPubMedCentral
26.
go back to reference Pandya ST, Chakravarthy K, Vemareddy A. Obstetric anaesthesia practice: dashboard as a dynamic audit tool. Indian J Anaesth. 2018;62(11):838–43.PubMedPubMedCentral Pandya ST, Chakravarthy K, Vemareddy A. Obstetric anaesthesia practice: dashboard as a dynamic audit tool. Indian J Anaesth. 2018;62(11):838–43.PubMedPubMedCentral
27.
go back to reference Cravero JP, Sriswasdi P, Lekowski R, Carpino E, Blum R, Askins N, et al. Creation of an integrated outcome database for pediatric anesthesia. Pediatr Anesth. 2016;26(4):345–55. Cravero JP, Sriswasdi P, Lekowski R, Carpino E, Blum R, Askins N, et al. Creation of an integrated outcome database for pediatric anesthesia. Pediatr Anesth. 2016;26(4):345–55.
29.
go back to reference Lamer A, Jeanne M, Vallet B, Ditilyeu G, Delaby F, Tavernier B, et al. Development of an anesthesia data warehouse: preliminary results. IRBM. 2013;34(6):376–8. Lamer A, Jeanne M, Vallet B, Ditilyeu G, Delaby F, Tavernier B, et al. Development of an anesthesia data warehouse: preliminary results. IRBM. 2013;34(6):376–8.
30.
go back to reference Lamer A, Jeanne M, Ficheur G, Marcilly R. Automated data aggregation for time-series analysis: study case on anaesthesia data warehouse. Stud Health Technol Inform. 2016;221:102–6.PubMed Lamer A, Jeanne M, Ficheur G, Marcilly R. Automated data aggregation for time-series analysis: study case on anaesthesia data warehouse. Stud Health Technol Inform. 2016;221:102–6.PubMed
31.
go back to reference Lamer A, Jeanne M, Marcilly R, Kipnis E, Schiro J, Logier R, et al. Methodology to automatically detect abnormal values of vital parameters in anesthesia time-series: proposal for an adaptable algorithm. Comput Methods Programs Biomed. 2016;129:160–71.PubMed Lamer A, Jeanne M, Marcilly R, Kipnis E, Schiro J, Logier R, et al. Methodology to automatically detect abnormal values of vital parameters in anesthesia time-series: proposal for an adaptable algorithm. Comput Methods Programs Biomed. 2016;129:160–71.PubMed
32.
go back to reference Lamer A, Demay A, Marcilly R. Data reuse through anesthesia data warehouse: searching for new use contexts. Stud Health Technol Inform. 2018;255:102–6.PubMed Lamer A, Demay A, Marcilly R. Data reuse through anesthesia data warehouse: searching for new use contexts. Stud Health Technol Inform. 2018;255:102–6.PubMed
33.
go back to reference Brown B, Balatsoukas P, Williams R, Sperrin M, Buchan I. Interface design recommendations for computerised clinical audit and feedback: hybrid usability evidence from a research-led system. Int J Med Inform. 2016;94:191–206.PubMedPubMedCentral Brown B, Balatsoukas P, Williams R, Sperrin M, Buchan I. Interface design recommendations for computerised clinical audit and feedback: hybrid usability evidence from a research-led system. Int J Med Inform. 2016;94:191–206.PubMedPubMedCentral
34.
go back to reference Hartzler AL, Chaudhuri S, Fey BC, Flum DR, Lavallee D. Integrating patient-reported outcomes into spine surgical care through visual dashboards: lessons learned from human-centered design. EGEMS (Wash DC). 2015;3(2):1133. Hartzler AL, Chaudhuri S, Fey BC, Flum DR, Lavallee D. Integrating patient-reported outcomes into spine surgical care through visual dashboards: lessons learned from human-centered design. EGEMS (Wash DC). 2015;3(2):1133.
35.
go back to reference Kluger AN, DeNisi A. The effects of feedback interventions on performance: a historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychol Bull. 1996;119(2):254–84. Kluger AN, DeNisi A. The effects of feedback interventions on performance: a historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychol Bull. 1996;119(2):254–84.
37.
go back to reference Welcome! The Apache HTTP Server Project. https:// apache.org/. Accessed 1 Dec 2019. Welcome! The Apache HTTP Server Project. https:// apache.org/. Accessed 1 Dec 2019.
38.
go back to reference Brooke J. SUS—A quick and dirty usability scale. Usability evaluation in industry. London: Taylor and Francis; 1996. Brooke J. SUS—A quick and dirty usability scale. Usability evaluation in industry. London: Taylor and Francis; 1996.
39.
go back to reference Bangor A, Kortum P, Miller J. Determining what individual SUS scores mean: adding an adjective rating scale. J Usability Stud. 2009;4(3):114–23. Bangor A, Kortum P, Miller J. Determining what individual SUS scores mean: adding an adjective rating scale. J Usability Stud. 2009;4(3):114–23.
40.
go back to reference Sessler DI, Bloomstone JA, Aronson S, Berry C, Gan TJ, Kellum JA, et al. Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Perioperative Quality Initiative-3 Workgroups. Br J Anaesth. 2019;122(5):563–74.PubMed Sessler DI, Bloomstone JA, Aronson S, Berry C, Gan TJ, Kellum JA, et al. Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Perioperative Quality Initiative-3 Workgroups. Br J Anaesth. 2019;122(5):563–74.PubMed
41.
go back to reference Ruscic KJ, Grabitz SD, Rudolph MI, Eikermann M. Prevention of respiratory complications of the surgical patient: actionable plan for continued process improvement. Curr Opin Anaesthesiol. 2017;30(3):399–408.PubMedPubMedCentral Ruscic KJ, Grabitz SD, Rudolph MI, Eikermann M. Prevention of respiratory complications of the surgical patient: actionable plan for continued process improvement. Curr Opin Anaesthesiol. 2017;30(3):399–408.PubMedPubMedCentral
42.
go back to reference Vallet B, Blanloeil Y, Cholley B, Orliaguet G, Pierre S, Tavernier B. Guidelines for perioperative haemodynamic optimization. Société française d’anesthésie et de réanimation. Ann Fr Anesth Reanim. 2013;32(10):e151–e158158.PubMed Vallet B, Blanloeil Y, Cholley B, Orliaguet G, Pierre S, Tavernier B. Guidelines for perioperative haemodynamic optimization. Société française d’anesthésie et de réanimation. Ann Fr Anesth Reanim. 2013;32(10):e151–e158158.PubMed
43.
go back to reference Desai N, Schofield N, Richards T. Perioperative patient blood management to improve outcomes. Anesth Analg. 2018;127(5):1211–20.PubMed Desai N, Schofield N, Richards T. Perioperative patient blood management to improve outcomes. Anesth Analg. 2018;127(5):1211–20.PubMed
44.
go back to reference Mathis MR, Naik BI, Freundlich RE, Shanks AM, Heung M, Kim M, et al. Preoperative risk and the association between hypotension and postoperative Acute Kidney Injury. Anesthesiology. 2020;132(3):461–75.PubMedPubMedCentral Mathis MR, Naik BI, Freundlich RE, Shanks AM, Heung M, Kim M, et al. Preoperative risk and the association between hypotension and postoperative Acute Kidney Injury. Anesthesiology. 2020;132(3):461–75.PubMedPubMedCentral
46.
go back to reference Dowding D, Merrill JA. The development of heuristics for evaluation of dashboard visualizations. Appl Clin Inform. 2018;09(03):511–8. Dowding D, Merrill JA. The development of heuristics for evaluation of dashboard visualizations. Appl Clin Inform. 2018;09(03):511–8.
47.
go back to reference Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. MIS Q. 2003;27(3):425–78. Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. MIS Q. 2003;27(3):425–78.
48.
go back to reference Birdas TJ, Rozycki GF, Dunnington GL, Stevens L, Liali V, Schmidt CM. “Show Me the Data”: a recipe for quality improvement success in an academic surgical department. J Am Coll Surg. 2019;228(4):368–73.PubMed Birdas TJ, Rozycki GF, Dunnington GL, Stevens L, Liali V, Schmidt CM. “Show Me the Data”: a recipe for quality improvement success in an academic surgical department. J Am Coll Surg. 2019;228(4):368–73.PubMed
Metadata
Title
Development, implementation and preliminary evaluation of clinical dashboards in a department of anesthesia
Authors
Géry Laurent
Mouhamed D. Moussa
Cédric Cirenei
Benoît Tavernier
Romaric Marcilly
Antoine Lamer
Publication date
01-05-2021
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 3/2021
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-020-00522-x

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