Reducing unwarranted variation: can a 'clinical dashboard' be helpful for hospital executive boards and top-level leaders?

Autor:	Tjomsland O; Helse Sor-Ost RHF, Hamar, Norway ole.tjomsland@helse-sorost.no.; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway., Thoresen C; Helse Sor-Ost RHF, Hamar, Norway., Ingebrigtsen T; Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.; Australian Institute of Health Innovation, Centre for Clinical Governance Research, University of New South Wales, Sydney, New South Wales, Australia., Søreide E; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.; Critical Care and Anaesthesiology Research Group, Helse Stavanger HF, Stavanger, Norway., Frich JC; Universitetet i Oslo Avdeling for samfunnsmedisin, Oslo, Norway.; Diakonhjemmet Hospital, Oslo, Norway.
Jazyk:	angličtina
Zdroj:	BMJ leader [BMJ Lead] 2024 Sep 18; Vol. 8 (3), pp. 186-190. Date of Electronic Publication: 2024 Sep 18.
DOI:	10.1136/leader-2023-000749
Abstrakt:	Background/aim: In the past decades, there has been an increasing focus on defining, identifying and reducing unwarranted variation in clinical practice. There have been several attempts to monitor and reduce unwarranted variation, but the experience so far is that these initiatives have failed to reach their goals. In this article, we present the initial process of developing a safety, quality and utilisation rate dashboard ('clinical dashboard') based on a selection of data routinely reported to executive boards and top-level leaders in Norwegian specialist healthcare. Methods: We used a modified version of Wennberg's categorisation of healthcare delivery to develop the dashboard, focusing on variation in (1) effective care and patient safety and (2) preference-sensitive and supply-sensitive care. Results: Effective care and patient safety are monitored with outcome measures such as 30-day mortality after hospital admission and 5-year cancer survival, whereas utilisation rates for procedures selected on cost and volume are used to follow variations in preference-sensitive and supply-sensitive care. Conclusion: We argue that selecting quality indicators of patient safety, quality and utilisation rates and presenting them in a dashboard may help executive hospital boards and top-level leaders to focus on unwarranted variation. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu