Measuring patient safety in a UK dental hospital: development of a dental clinical effectiveness dashboard

Identifying and prioritizing the key performance indicators for hospital management dashboard at a national level: Viewpoint of hospital managers

Participation of main users in identifying key performance indicators (KPIs) for management dashboards contributes to their success. The aim of this study was to identify and prioritize the KPIs of hospital management dashboards from the viewpoint of hospital managers. This study was conducted on managers of public hospitals at a national level in Iran in 2020. Data were collected using a self-administrated questionnaire. The KPIs were classified into five categories, namely financial, operational, human resources, safety and quality of care, services provided to patients. A total of 234 hospital managers participated in this study. Totally, 25 KPIs were determined for the hospital management dashboard, including the patient falls rate, waiting time for patients in the emergency department, patient satisfaction, total hospital revenue, financial balance, bed occupancy rate, patients' discharge with own agreement, average length of stay, and personnel satisfaction. For designing hospital management dashboards, the domains of services provided to patients, safety and quality of care, financial resources, human resources, and operational are important from the hospital managers' viewpoint, respectively. The results of this study can be helpful for developers of business intelligence tools, such as hospital management dashboards, to visualize the most important indicators for managers.

Development of an electronic learning progression dashboard to monitor student clinical experiences

INTRODUCTION

Clinical experience tracking mechanisms for students at dental schools provide patient assignment, student experience, and learning progression feedback. The purpose of this study was to evaluate dental students' clinical experiences following the implementation of a learning progression dashboard (LPD).

METHODS

After developing and deploying an electronic LPD using PHP, secondary data analysis on dental students' clinical experiences from 2017-2019 was conducted. Student experience differences were compared between the year before continuous use of the LPD and the first year using it. LPD data contained the required clinical procedures dentistry students must perform across all disciplines and the number of planned, in progress, and completed tasks each student has accomplished. Using two time points, the students' experiences were compared. Univariate statistics and independent t-tests were conducted in R for detecting the differences in the number and categories of codes.

RESULTS

The number and category of codes showed significant differences between the academic year 2017-2018 and 2018-2019 for both third- and fourth-year dental students after one and two terms. Overall, students recorded a 26% greater number of treatment codes and experienced a 26% greater number of code categories compared to the previous year.

CONCLUSION

Applying information management methods such as dashboards can better inform educators on student clinical experiences and improve clinical learning outcomes for students.

Dashboards for visual display of patient safety data: a systematic review

Background

Methods to visualise patient safety data can support effective monitoring of safety events and discovery of trends. While quality dashboards are common, use and impact of dashboards to visualise patient safety event data remains poorly understood.

Objectives

To understand development, use and direct or indirect impacts of patient safety dashboards.

Methods

We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, EMBASE and CINAHL for publications between 1 January 1950 and 30 August 2018 involving use of dashboards to display data related to safety targets defined by the Agency for Healthcare Research and Quality’s Patient Safety Net. Two reviewers independently reviewed search results for inclusion in analysis and resolved disagreements by consensus. We collected data on development, use and impact via standardised data collection forms and analysed data using descriptive statistics.

Results

Literature search identified 4624 results which were narrowed to 33 publications after applying inclusion and exclusion criteria and consensus across reviewers. Publications included only time series and case study designs and were inpatient focused and emergency department focused. Information on direct impact of dashboards was limited, and only four studies included informatics or human factors principles in development or postimplementation evaluation.

Discussion

Use of patient-safety dashboards has grown over the past 15 years, but impact remains poorly understood. Dashboard design processes rarely use informatics or human factors principles to ensure that the available content and navigation assists task completion, communication or decision making.

Conclusion

Design and usability evaluation of patient safety dashboards should incorporate informatics and human factors principles. Future assessments should also rigorously explore their potential to support patient safety monitoring including direct or indirect impact on patient safety.

Significance of Patient Safety and Safety Culture in Dental Schools: A Systematic Review

Objectives:

This article aims to systematically review and analyze the outcome of published literature on patient safety and safety culture related to dental schools. It also aims to observe implemented changes in dental school training and curriculum that have improved patient safety and safety culture within institutions.

Methods:

All studies concerning patient safety and safety culture from the period of January 2010 to May 2020 were included which were specific to dental educational institution settings. The assessment was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist to ascertain that the included studies were specific to the objective of our systematic review.

Results:

The included studies were assessed for country-wise publication, type of study, and its outcome. Of the 10 studies that met the inclusion criteria, 5 articles were related to patient safety. 2 out of the 5 articles were from the United States of America (USA) 2 were from the United Kingdom (UK), followed by 1 from Mexico. For articles related to safety culture, 3 out of the 5 articles were from Saudi Arabia, and 2 were from the USA.

Conclusion:

The analysis of the selected review articles suggests that rigorous training should be implemented in inpatient record documentation, incident reporting, and infection control protocols. The authors suggested focused training on patient safety culture and the inclusion of safety culture awareness and training to the dental undergraduate curriculum.

Patient safety in dental care: an integrative review

Adverse events pose a serious problem for quality of healthcare. Dental practice is eminently invasive and involves close and routine contact with secretions; as such, it is potentially prone to the occurrence of adverse events. Various patient safety studies have been developed in the last two decades, but mostly in the hospital setting due to the organizational complexity, severity of the cases, and diversity and specificity of the procedures. The objective was to identify and explore studies on patient safety in Dentistry. An integrative literature review was performed in MEDLINE via PubMed, Scopus via Portal Capes, and the Regional Portal of the Virtual Health Library, using the terms patient safety and dentistry in English, Spanish, and Portuguese, starting in 2000. The research cycle in patient safety was used, as proposed by the World Health Organization to classify studies. We analyzed 91 articles. The most common adverse events were allergies, infections, diagnostic delay or failure, and technical error. Measures to mitigate the problem highlight the need to improve communications, encourage reporting, and search for tools to assist the management of care. The authors found a lack of studies on implementation and assessment of the impact of proposals for improvement. Dentistry has made progress in patient safety but still needs to transpose the results into practice, where efforts are crucial to prevent adverse events.

Impact of early clinical exposure on the learning experience of undergraduate dental students

AIMS

The aim of this research was to evaluate the impact of early clinical exposure on the learning experiences of undergraduate dental students.

METHODS

This study was based on mixed methods. The first phase involved administering a purposely designed questionnaire consisting of 16 items, grouped into three subscales. The second phase of the research was conducted using qualitative semi-structured interviews to explore the perceptions and experiences of stakeholders regarding early clinical exposure.

RESULTS

In total, 134 undergraduate dental students and eight clinical supervisors responded to the questionnaire and reported positive perceptions regarding the learning experiences, professional relationship and learning environment. Qualitative interviews were conducted with 12 participants, and early clinical exposure was perceived to be useful in providing a context to theoretical learning and development of interpersonal skills. Curriculum overload and further need for consolidation were highlighted as the main challenges.

CONCLUSIONS

This study provided insights into the clinical training model in an undergraduate dental programme and highlights the benefits and challenges of early clinical exposure in the study population. The study served as a vehicle for engagement with a range of stakeholders using a mixed methods approach to inform further development of the training model.

How dental team members describe adverse events

BACKGROUND

Although some patients experience adverse events (AEs) resulting in harm caused by treatments in dentistry, few published reports have detailed how dental providers describe these events. Understanding how dental treatment professionals view AEs is essential to building a safer environment in dental practice.

METHODS

The authors interviewed dental professionals and domain experts through focus groups and in-depth interviews and asked them to identify the types of AEs that may occur in dental settings.

RESULTS

The initial interview and focus group findings yielded 1,514 items that included both causes and AEs. In total, 632 causes were coded into 1 of the 8 categories of the Eindhoven classification, and 882 AEs were coded into 12 categories of a newly developed dental AE classification. Interrater reliability was moderate among coders. The list was reanalyzed, and duplicate items were removed leaving a total of 747 unique AEs and 540 causes. The most frequently identified AE types were "aspiration and ingestion" at 14% (n = 142), "wrong-site, wrong-procedure, wrong-patient errors" at 13%, "hard-tissue damage" at 13%, and "soft-tissue damage" at 12%.

CONCLUSIONS

Dental providers identified a large and diverse list of AEs. These events ranged from "death due to cardiac arrest" to "jaw fatigue from lengthy procedures."

PRACTICAL IMPLICATIONS

Identifying threats to patient safety is a key element of improving dental patient safety. An inventory of dental AEs underpins efforts to track, prevent, and mitigate these events.

A Map for Clinical Laboratories Management Indicators in the Intelligent Dashboard

INTRODUCTION

management challenges of clinical laboratories are more complicated for educational hospital clinical laboratories. Managers can use tools of business intelligence (BI), such as information dashboards that provide the possibility of intelligent decision-making and problem solving about increasing income, reducing spending, utilization management and even improving quality. Critical phase of dashboard design is setting indicators and modeling causal relations between them. The paper describes the process of creating a map for laboratory dashboard.

METHODS

the study is one part of an action research that begins from 2012 by innovation initiative for implementing laboratory intelligent dashboard. Laboratories management problems were determined in educational hospitals by the brainstorming sessions. Then, with regard to the problems key performance indicators (KPIs) specified.

RESULTS

the map of indicators designed in form of three layered. They have a causal relationship so that issues measured in the subsequent layers affect issues measured in the prime layers.

CONCLUSION

the proposed indicator map can be the base of performance monitoring. However, these indicators can be modified to improve during iterations of dashboard designing process.