Emergency Department Quality Dashboard; a Systematic Review of Performance Indicators, Functionalities, and Challenges

Usability and Evaluation of a Health Information System in the Emergency Department: Mixed Methods Study

BACKGROUND

A lack of information during an emergency visit leads to the experience of powerlessness for patients and their family members, who may also feel unprepared to cope with acute symptoms. The ever-changing nature and fast-paced workflow in the emergency department (ED) often affect how health care professionals can tailor information and communication to the needs of the patient.

OBJECTIVE

This study aimed to evaluate the usability and experience of a newly developed information system. The system was developed together with patients and their family members to help provide the information needed in the ED.

METHODS

We conducted a mixed methods study consisting of quantitative data obtained from the System Usability Scale questionnaire and qualitative interview data obtained from purposively selected participants included in the quantitative part of the study.

RESULTS

A total of 106 patients and 14 family members (N=120) answered the questionnaire. A total of 10 patients and 3 family members participated in the interviews. Based on the System Usability Scale score, the information system was rated close to excellent, with a mean score of 83.6 (SD 12.8). Most of the participants found the information system easy to use and would like to use it again. The participants reported that the system helped them feel in control, and the information was useful. Simplifications were needed to improve the user experience for the older individuals.

CONCLUSIONS

This study demonstrates that the usability of the information system is rated close to excellent. It was perceived to be useful as it enabled understanding and predictability of the patient's trajectory in the ED. Areas for improvement include making the system more usable by older individuals. The study provides an example of how a technological solution can be used to diminish the information gap in an ED context.

Developing public health surveillance dashboards: a scoping review on the design principles

BACKGROUND

Public Health Dashboards (PHDs) facilitate the monitoring and prediction of disease outbreaks by continuously monitoring the health status of the community. This study aimed to identify design principles and determinants for developing public health surveillance dashboards.

METHODOLOGY

This scoping review is based on Arksey and O'Malley's framework as included in JBI guidance. Four databases were used to review and present the proposed principles of designing PHDs: IEEE, PubMed, Web of Science, and Scopus. We considered articles published between January 1, 2010 and November 30, 2022. The final search of articles was done on November 30, 2022. Only articles in the English language were included. Qualitative synthesis and trend analysis were conducted.

RESULTS

Findings from sixty-seven articles out of 543 retrieved articles, which were eligible for analysis, indicate that most of the dashboards designed from 2020 onwards were at the national level for managing and monitoring COVID-19. Design principles for the public health dashboard were presented in five groups, i.e., considering aim and target users, appropriate content, interface, data analysis and presentation types, and infrastructure.

CONCLUSION

Effective and efficient use of dashboards in public health surveillance requires implementing design principles to improve the functionality of these systems in monitoring and decision-making. Considering user requirements, developing a robust infrastructure for improving data accessibility, developing, and applying Key Performance Indicators (KPIs) for data processing and reporting purposes, and designing interactive and intuitive interfaces are key for successful design and development.

[Indicators to measure the performance of emergency trauma care]

The objective of this paper was to identify the main indicators used to measure the performance in emergency trauma care. A literature review was carried out in the electronic databases: PubMEd, LILACS and Epistemónikos, including publications between January 2011 and December 31, 2021, in Spanish, English and Portuguese. A total of 962 publications were identified. When reviewing the full text, 48 articles were included. The indicators were classified in the dimensions of process and results. 100 different indicators were identified to analyze the performance of emergency trauma care. 71% were process indicators, including service time and triage. In the results dimension 29 indicators were identified; mortality was the indicator most analyzed as well as length of stay. Six indicators on the disability of injured people and 14 indicators related to satisfaction were identified, the most frequent being complaints. Various indicators have been used to assess the performance of emergency trauma care. In the results dimension, the indicators related to satisfaction and disability after injuries have been little explored. Decision-makers and those responsible for emergency care must promote performance evaluation exercises to learn about their current situation using appropriate and sensitive indicators with the available data.

Usability Evaluation of Dashboards: A Systematic Literature Review of Tools

Introduction

In recent years, the use of dashboards in healthcare has been considered an effective approach for the visual presentation of information to support clinical and administrative decisions. Effective and efficient use of dashboards in clinical and managerial processes requires a framework for the design and development of tools based on usability principles.

Objectives

The present study is aimed at investigating the existing questionnaires used for the usability evaluation framework of dashboards and at presenting more specific usability criteria for evaluating dashboards.

Methods

This systematic review was conducted using PubMed, Web of Science, and Scopus, without any time restrictions. The final search of articles was performed on September 2, 2022. Data collection was performed using a data extraction form, and the content of selected studies was analyzed based on the dashboard usability criteria.

Results

After reviewing the full text of relevant articles, a total of 29 studies were selected according to the inclusion criteria. Regarding the questionnaires used in the selected studies, researcher-made questionnaires were used in five studies, while 25 studies applied previously used questionnaires. The most widely used questionnaires were the System Usability Scale (SUS), Technology Acceptance Model (TAM), Situation Awareness Rating Technique (SART), Questionnaire for User Interaction Satisfaction (QUIS), Unified Theory of Acceptance and Use of Technology (UTAUT), and Health Information Technology Usability Evaluation Scale (Health-ITUES), respectively. Finally, dashboard evaluation criteria, including usefulness, operability, learnability, ease of use, suitability for tasks, improvement of situational awareness, satisfaction, user interface, content, and system capabilities, were suggested.

Conclusion

General questionnaires that were not specifically designed for dashboard evaluation were mainly used in reviewed studies. The current study suggested specific criteria for measuring the usability of dashboards. When selecting the usability evaluation criteria for dashboards, it is important to pay attention to the evaluation objectives, dashboard features and capabilities, and context of use.

Requirements and challenges of hospital dashboards: a systematic literature review

Background

Today, the use of data in administrative and clinical processes is quite challenging due to the large volume of data, data collection from various sources, and lack of data structure. As a data management tool, dashboards play an important role in timely visual display of critical information on key performances.

Objectives

This systematic review aimed to identify functional and non-functional requirements, as well as challenges of using dashboards in hospitals.

Methods

In this systematic review, four databases, including the Web of Science, PubMed, EMBASE, and Scopus, were searched to find relevant articles from 2000 until May 30, 2020. The final search was conducted on May 30, 2020. Data collection was performed using a data extraction form and reviewing the content of relevant studies on the potentials and challenges of dashboard implementation.

Results

Fifty-four out of 1254 retrieved articles were selected for this study based on the inclusion and exclusion criteria. The functional requirements for dashboards included reporting, reminders, customization, tracking, alert creation, and assessment of performance indicators. On the other hand, the non-functional requirements included the dashboard speed, security, ease of use, installation on different devices (e.g., PCs and laptops), integration with other systems, web-based design, inclusion of a data warehouse, being up-to-data, and use of data visualization elements based on the user’s needs. Moreover, the identified challenges were categorized into four groups: data sources, dashboard content, dashboard design, implementation, and integration in other systems at the hospital level.

Conclusion

Dashboards, by providing information in an appropriate manner, can lead to the proper use of information by users. In order for a dashboard to be effective in clinical and managerial processes, particular attention must be paid to its capabilities, and the challenges of its implementation need to be addressed.

Integrating training, practice, and reflection within a new model for Canadian medical licensure: a concept paper prepared for the Medical Council of Canada

In 2020 the Medical Council of Canada created a task force to make recommendations on the modernization of its practices for granting licensure to medical trainees. This task force solicited papers on this topic from subject matter experts. As outlined within this Concept Paper, our proposal would shift licensure away from the traditional focus on high-stakes summative exams in a way that integrates training, clinical practice, and reflection. Specifically, we propose a model of graduated licensure that would have three stages including: a trainee license for trainees that have demonstrated adequate medical knowledge to begin training as a closely supervised resident, a transition to practice license for trainees that have compiled a reflective educational portfolio demonstrating the clinical competence required to begin independent practice with limitations and support, and a fully independent license for unsupervised practice for attendings that have demonstrated competence through a reflective portfolio of clinical analytics. This proposal was reviewed by a diverse group of 30 trainees, practitioners, and administrators in medical education. Their feedback was analyzed and summarized to provide an overview of the likely reception that this proposal would receive from the medical education community.