Place your cards on the Table: Unit-driven Nursing Dashboards

Purpose:
Nurse leaders must prioritize and manage numerous complex pieces of data, and clearly communicate important nurse-sensitive outcome data to direct care nurses. A large health system created unit level dashboards to help nurses understand and act upon important quality information.

Significance:
With so many competing priorities, it is critical for nurse leaders to prioritize the data they receive. Pinpointing and sharing critical metrics can drive problem recognition, facilitate performance improvement and ignite front line staff to improve patient care quality, safety and service.

Strategy and Implementation:
System nursing leadership decided to develop unit-level quality dashboards that were easy to read and interpret, and demonstrated performance trends. Nurse leaders believed that unit councils must be involved in prioritizing critical metrics, recognizing problems and taking action to improve. Nurses in unit councils chose indicators for the dashboards that their unit would monitor and use to improve patient care, including skin, falls, 2 other clinical indicators, and 2 service indicators. The Clinical Information Analysis Dept. provided nurse leaders with a list of nurse sensitive outcome indicators they were already retrieving electronically. Fortunately, 75% of the selected indicators were on the list. For those non-electronic indicators, nurse leaders created operational definitions. Dashboards also include hospital performance goals, trends, and national benchmarks when available. Dashboards are posted to the Nursing Portal monthly.

Evaluation:
The dashboards make a large amount of critical data accessible and understandable to staff. Use of color-coding provides an instant snapshot of unit performance, thus helping nurses prioritize their efforts in affecting change. Individual indicator trends help nurses monitor progress.

Implications for Practice:
Direct care nurses and leaders must work together to identify key metrics, interpret the data, and use the data to drive performance. The dashboards provide a tool to facilitate nursing quality improvement and demonstrate the impact nurses have on patient quality, safety and service.