Background Several countries have national policies and programmes requiring hospitals to use quality and safety (QS) indicators. To present an overview of these indicators, hospital-wide QS (HWQS) dashboards are designed. There is little evidence how these dashboards are developed. The challenges faced to develop these dashboards in Dutch hospitals were retrospectively studied.
Methods 24 focus group interviews were conducted: 12 with hospital managers (n=25; 39.7%) and 12 support staff (n=38; 60.3%) in 12 of the largest Dutch hospitals. Open and axial codings were applied consecutively to analyse the data collected.
Results A heuristic tool for the general development process for HWQS dashboards containing five phases was identified. In phase 1, hospitals make inventories to determine the available data and focus too much on quantitative data relevant for accountability. In phase 2, hospitals develop dashboard content by translating data into meaningful indicators for different users, which is not easy due to differing demands. In phase 3, hospitals search for layouts that depict the dashboard content suited for users with different cognitive abilities and analytical skills. In phase 4, hospitals try to integrate dashboards into organisational structures to ensure that data are systematically reviewed and acted on. In phase 5, hospitals want to improve the flexibility of their dashboards to make this adaptable under differing circumstances.
Conclusion The literature on dashboards addresses the technical and content aspects of dashboards, but overlooks the organisational development process. This study shows how technical and organisational aspects are relevant in development processes.
- healthcare quality improvement
- performance measures
- quality measurement
- report cards
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Contributors AMJWMW contributed to the study design, acquisition of data, analysis, interpretation of data and prepared the manuscript. DSEB contributed to the interpretation of the data and prepared the manuscript. MdB contributed to the study design, acquisition of the data and commented on manuscript drafts. All authors have approved the final manuscript.
Funding The research was funded by the Citrien Fonds of ZonMW (grant 8392010042) and conducted on behalf of the Dutch Federation of University Medical Centers’ Quality Steering programme.
Competing interests None declared.
Patient consent Not required.
Ethics approval Ethics approval for this study is not necessary under Dutch law as no patient data were collected. Written consent was obtained from the respondents.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The datasets supporting this article are available in the repository of the Erasmus University Rotterdam. Contact the authors for access.
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