Development and Implementation of a Real-time Bundle-adherence Dashboard for Central Line-associated Bloodstream Infections

Augustine Chemparathy; Martin G Seneviratne; Andrew Ward; Simran Mirchandani; Ron Li; Roshni Mathew; Matthew Wood; Andrew Y Shin; Lane F Donnelly; David Scheinker; Grace M Lee

doi:10.1097/pq9.0000000000000431

Development and Implementation of a Real-time Bundle-adherence Dashboard for Central Line-associated Bloodstream Infections

Pediatr Qual Saf. 2021 Jun 23;6(4):e431. doi: 10.1097/pq9.0000000000000431. eCollection 2021 Jul-Aug.

Authors

Affiliations

¹ Department of Management Science and Engineering, Stanford University, Stanford, Calif.
² Department of Biomedical Informatics, Stanford University, Stanford, Calif.
³ Department of Electrical Engineering, Stanford University School of Engineering, Stanford, Calif.
⁴ Center for Biomedical Informatics Research, Stanford University School of Medicine, Stanford, Calif.
⁵ Lucile Packard Children's Hospital, Stanford University, Stanford, Calif.

Abstract

Introduction: Central line-associated bloodstream infections (CLABSIs) are the most common hospital-acquired infection in pediatric patients. High adherence to the CLABSI bundle mitigates CLABSIs. At our institution, there did not exist a hospital-wide system to measure bundle-adherence. We developed an electronic dashboard to monitor CLABSI bundle-adherence across the hospital and in real time.

Methods: Institutional stakeholders and areas of opportunity were identified through interviews and data analyses. We created a data pipeline to pull adherence data from twice-daily bundle checks and populate a dashboard in the electronic health record. The dashboard was developed to allow visualization of overall and individual element bundle-adherence across units. Monthly dashboard accesses and element-level bundle-adherence were recorded, and the nursing staff's feedback about the dashboard was obtained.

Results: Following deployment in September 2018, the dashboard was primarily accessed by quality improvement, clinical effectiveness and analytics, and infection prevention and control. Quality improvement and infection prevention and control specialists presented dashboard data at improvement meetings to inform unit-level accountability initiatives. All-element adherence across the hospital increased from 25% in September 2018 to 44% in December 2019, and average adherence to each bundle element increased between 2018 and 2019.

Conclusions: CLABSI bundle-adherence, overall and by element, increased across the hospital following the deployment of a real-time electronic data dashboard. The dashboard enabled population-level surveillance of CLABSI bundle-adherence that informed bundle accountability initiatives. Data transparency enabled by electronic dashboards promises to be a useful tool for infectious disease control.