Development, implementation and user experience of the Veterans Health Administration (VHA) dialysis dashboard

被引:10
作者
Fischer, Michael J. [1 ,2 ,3 ]
Kourany, Wissam M. [4 ,5 ]
Sovern, Karen [6 ]
Forrester, Kurt [7 ]
Griffin, Cassandra [8 ]
Lightner, Nancy [9 ]
Loftus, Shawn [7 ]
Murphy, Katherine [7 ]
Roth, Greg [6 ]
Palevsky, Paul M. [10 ,11 ]
Crowley, Susan T. [8 ,12 ]
机构
[1] Jesse Brown VA Med Ctr, Chicago, IL 60612 USA
[2] Edward Hines Jr VA Hosp, Ctr Innovat Complex Chron Healthcare, 5000 S 5th Ave,151H, Hines, IL 60141 USA
[3] Univ Illinois Hosp & Hlth Sci Ctr, Chicago, IL 60612 USA
[4] Vet Affairs Durham Healthcare Syst, Durham, NC USA
[5] Duke Univ, Durham, NC USA
[6] Cincinnati VA Med Ctr, Cincinnati, OH USA
[7] Dept Vet Affairs, Washington, DC USA
[8] VA Connecticut Healthcare Syst, West Haven, CT USA
[9] Vet Management Serv Inc, Indianapolis, IN USA
[10] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA
[11] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA
[12] Yale Univ, Sch Med, New Haven, CT USA
关键词
Hemodialysis; End-stage renal disease; Veteran; Performance measures; Implementation; UNINTENDED CONSEQUENCES; PERFORMANCE-MEASUREMENT; MEASURING QUALITY; CARE; SYSTEM; VA; EFFICIENCY; ACCURACY; EASE;
D O I
10.1186/s12882-020-01798-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background Adults with end-stage renal disease (ESRD) requiring chronic dialysis continue to suffer from poor health outcomes and represent a population rightfully targeted for quality improvement. Electronic dashboards are increasingly used in healthcare to facilitate quality measurement and improvement. However, detailed descriptions of the creation of healthcare dashboards are uncommonly available and formal inquiry into perceptions, satisfaction, and utility by clinical users has been rarely conducted, particularly in the context of dialysis care. Therefore, we characterized the development, implementation and user experience with Veterans Health Administration (VHA) dialysis dashboard. Methods A clinical-quality dialysis dashboard was implemented, which displays clinical performance measures (CPMs) for Veterans with ESRD receiving chronic hemodialysis at all VHA facilities. Data on user experience and perceptions were collected via an e-mail questionnaire to dialysis medical directors and nurse managers at these facilities. Results Since 2016 the dialysis dashboard reports monthly on CPMs for approximately 3000 Veterans receiving chronic hemodialysis across 70 VHA dialysis facilities. Of 141 dialysis medical directors and nurse managers, 61 completed the questionnaire. Sixty-six percent of respondents did not find the dashboard difficult to access, 64% agreed that it is easy to use, 59% agreed that its layout is good, and the majority agreed that presentation of data is clear (54%), accurate (56%), and up-to-date (54%). Forty-eight percent of respondents indicated that it helped them improve patient care while 12% did not. Respondents indicated that they used the dialysis dashboard for clinical reporting (71%), quality assessment/performance improvement (QAPI) (62%), and decision-making (23%). Conclusions Most users of the VHA dialysis dashboard found it accurate, up-to-date, easy to use, and helpful in improving patient care. It meets diverse user needs, including administrative reporting, clinical benchmarking and decision-making, and quality assurance and performance improvement (QAPI) activities. Moreover, the VHA dialysis dashboard affords national-, regional- and facility-level assessments of quality of care, guides and motivates best clinical practices, targets QAPI efforts, and informs and promotes population health management improvement efforts for Veterans receiving chronic hemodialysis.
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页数:12
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