Investigating Analytics Dashboards’ Support for the Value-based Healthcare Delivery Model

Improving the value of care is one of the essential aspects of Value-Based Healthcare (VBHC) model today. VBHC is a new HC delivery model which is centered on patient health outcomes and improvements. There is anecdotal evidence that the use of decision aid tools like dashboards can play a significant role in the successful implementation of VBHC models. However, there has been little or no systematic studies and reviews to establish the extent to which analytics dashboards are used to support patient care in a VBHC delivery context. This paper bridges this knowledge gap through a systematic review of the existing literature on dashboards in the HC domain. Our study reveals dashboard capabilities as an enabling tool for value improvements and provides insight into the design of dashboards. This study concludes by highlighting a few gaps, question, and need for research in the future

Population Health Research: Early Description of the Organizational Shift Toward Population Health Management and Defining a Vision for Leadership.

As health care delivery systems adapt to the changing marketplace, many struggle to define a clear strategy that will prove successful in managing the health of entire populations. The federal government continues to put increasing pressure on organizations to shift away from the traditional way of delivering episodic care and move toward managing populations as a whole-before, during, and after a patient presents in a health care facility. Private payers have begun to follow suit as risk-based payer contracts and bundled payment models become increasingly popular. For organizations to adequately influence the health outcomes of a population, they must be responsible for more than just a patient\u27s medical care. They must partner with the community to create a strategy that encompasses the psychosocial and environmental factors that contribute to one\u27s health. Although health care leaders know this industry transformation is imminent, there is minimal research that shares best practices in regard to designing and implementing a successful population health management strategy. Interviews were conducted with leadership from 10 organizations in order to understand the strategic approach taken by delivery systems and health care institutions that view population health as a key aspect of their overall mission. Responses were recorded and outlined in a detailed response grid. The objective is to provide a qualitative overview of how industry leaders are currently responding to population health. Additionally, common themes and recommendations are presented to serve as guidance for other health care organizations that are at the start of their journey toward population health management

Optimising hospital designs and processes to improve efficiency and enhance the user experience

The health sector is facing increasing pressure to provide effective, efficient, and affordable care to the population it serves. The National Health Service (NHS) of the United Kingdom (UK) has regularly faced scrutiny with NHS England being issued a number of challenges in recent years to improve operational efficiency, reduce wasted space, and cut expenditure. The most recent challenge issued to NHS England has seen a requirement to save £5bn per annum by 2020, while reducing wasted space from 4.4% to 2.5% across the NHS estate. Similarly, satisfaction in the health service is also under scrutiny as staff retention and patient experiences are used in determining the performance of facilities. [Continues.

Wisdom at Work: Retaining Experienced RNs and Their Knowledge: Case Studies of Top Performing Organizations

Presents seven case studies of top organizations in the healthcare sector and beyond and their proven and innovative strategies for retaining experienced workers. Identifies elements of success, best practices, and lessons for the nursing field overall

The Design, implementation and Evaluation of a Technology Solution to Improve Discharge Planning Communication in a Complex Patient Population

Unnecessary delays in discharge planning can extend the length of stay (LOS) and add non-reimbursable days for socially and medically complex patients thereby increasing the financial burden to healthcare organizations. The literature supports enhanced discharge communication strategies and the use of checklists to facilitate safe and timely discharges. Following root cause analyses of significant discharge delays, one hospital identified gaps in communication as key precursors associated with discharge planning breakdown when discharging patients to skilled nursing facilities. Review of these events demonstrated the need for concurrent communication strategies between multidisciplinary care team members in planning for complex discharges. Following a complete assessment of the current discharge planning process, a web-based interactive discharge checklist was designed, implemented and evaluated in the attempt to provide guided communications to the essential partners of the patient’s team in an effort to reduce LOS and readmissions. After a six-month rollout of the new technology and concomitant procedures, the analyses revealed improvement in both the patient’s perception of discharge planning and the ability to discharge patients by noon. Results for LOS and readmission demonstrated inconsistent improvement. The use of an electronic checklist as a communication tool did reduce variability in discharge procedures and provided for continuity in handoff communication between team members. Staff agreed it promoted continuity and improved efficiency

Wearable continuous vital sign monitoring for deterioration detection and clinical outcomes in hospitalised patients

 Current practice uses physiological early warning scoring (EWS) systems to monitor “standard” vital signs, including heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturations (SpO2) and temperature, coupled with a graded response such as referral for a senior review or increasing monitoring frequency. Early detection of the deteriorating patient is a known challenge within hospital environments, as EWS is dependent on correct frequency of physiological observations tailored to specific patient needs, that can be time consuming for healthcare professionals, resulting in missed or incomplete observations. Wearable monitoring systems (WMS) may bring the potential to fill the gap in vital sign monitoring between traditional intermittent manual measurements and continuous automatic monitoring. However, evidence on the feasibility and impact of WMS implementation remains scarce. The virtual High Dependency Unit (vHDU) project was designed to develop and test the feasibility of deploying a WMS system in the hospital ward environment. This doctoral work aims to critically analyse the roadmap work of the vHDU project, containing ten publications distributed throughout 7 chapters. Chapter 1 (with 3 publications) includes a systematic review and meta-analysis identifying the lack of statistical evidence of the impact of WMS in early deterioration detection and associated clinical outcomes, highlighting the need for high-quality randomised controlled trials (RCTs). It also supports the use of WMS as a complement, and not a substitute, for standard and direct care. Chapter 2 explores clinical staff and patient perceptions of current vital sign monitoring practices, as well as their early thoughts on the use of WMS in the hospital environment through a qualitative interview study. WMS were seen positively by both clinical and patient groups as a potential tool to bridge the gap between manual observations and the traditional wired continuous automatic systems, as long as it does not add more noise to the wards nor replaces direct contact from the clinical staff. In chapter 3, the wearability of 7 commercially available wearables (monitoring HR, RR and SpO2) was assessed, advocating for the use of pulse oximeters without a fingertip probe and a small chest patch to improve worn times from the patients. Out of these, five devices were submitted to measurement accuracy testing (chapter 4, with 3 publications) under movement and controlled hypoxaemia, resulting in the validation of a chest patch (monitoring HR and RR) and proving the diagnostic accuracy of 3 pulse oximeters (monitoring pulse rate, PR and SpO2) under test. These results were timely for the final selection of the devices to be integrated in our WMS, namely vHDU system, explored in chapter 5, outlining the process for its development and rapid deployment in COVID-19 isolation wards in our local hospital during the pandemic. This work is now converging in the design of a feasibility RCT to test the impact of the vHDU system (now augmented with blood pressure and temperature monitoring, completing all 5 vital signs) versus standard care in an unbiased environment (chapter 6). This will also ascertain the feasibility for a multicentre RCT, that may in the future, contribute with the much-needed statistical evidence to my systematic review and meta-analysis research question, highlighted in chapter 1. Finally, chapter 7 includes a critical reflection of the vHDU project and overall doctoral work, as well as its contributions to the field of wearable monitoring.<p class="MsoNormal"/

Creating Equity Reports: A Guide for Hospitals

Offers a framework for equity reporting -- identifying ethnic and racial disparities in hospitals and ways to reduce them -- including implementation, data collection, quality measures, and utilization. Reviews case studies and lessons learned