Digital dashboards and staffing: A perfect match - Myla Wagner ...

Practice Matters —
Digital dashboards and
staffing: A perfect match
By Kathy Douglas, MHA, RN
MANY HEALTHCARE
organizations use digital
“dashboards” to
provide employees
with real-time data
collected from
various sources,
helping to
guide decisions
and improve
the
quality of care.
Increasingly,
dashboards also
are being
used to support
effective staffing
decisions.
Whether part of
a software program
or a stand-alone product,
a digital dashboard
provides a visual way to
manage large amounts of data
by bringing together and displaying
selected data elements related to a specific
need. Dashboards organize information in meaningful
ways, making the data more useful and promoting
better communication and decision making.
Various types of displays, such as charts and graphs,
make large amounts of data easier to interpret.
Staffing, data, and decision making
Staffing plays an important role in the operational
and financial performance of a healthcare organization.
Staffing levels can be linked to labor costs, patient
safety, quality of care, length of stay, readmissions,
throughput, turnover, and staff satisfaction.
Thus, staffing decisions can broadly affect an organization’s
performance. Yet staffing has become more
complex, so dashboards that improve communication
and staffing decisions are imperative.
Although most of us understand the implications of
staffing decisions, many facilities still use antiquated
Dashboards that gather and
display staffing data aid
decision making in the
increasingly complex arena
of healthcare staffing.
staffing strategies, designs,
and operations
that are paper-based
and driven by
opinion and tradition.
This situation
has inspired
many
nursing professionals
to rethink
staffing
strategies;
create new
staffing models
based on evidence;
revisit
staffing practices,
policies, and procedures;
and redesign
technology solutions
to better serve
the foundational aspects
of a successful healthcare organization.
What data are needed?
The data needed to make informed staffing decisions
fall into three categories: patients, care team, and organization.
Patient data. Healthcare providers obviously need to
understand patients’ care requirements, such as level
of care, stability of condition, procedures needed, educational
background, level of cooperation, family situation,
and related issues (such as language barriers and
belief system).
Care-team data. Required information includes
staff availability, role, role and skill competencies,
hours worked, fatigue level, minimum commitment
compliance (for example, per diem commitment),
schedule (for continuity and fatigue considerations),
and costs (which may include base salary, overtime
implications, incentive use, and impact on budget).
Organizational data. Required information includes
admissions, discharges, policies and proce-
52 American Nurse Today Volume 5, Number 5 www.AmericanNurseToday.com

Using a digital staffing dashboard
Improving efficiency and effectiveness for both managers and staff, digital
dashboards offer various types of views, with different data levels and
capabilities depending on the end-user’s preferences and requirements.
For instance, in a clinical unit, the nurse manager may be able to log onto a
computer to view a dashboard that shows the staffing situation for the next
few days. From the dashboard display, she can easily identify:
• staffing requirements, budgeted and adjusted to the current patient
population
• assigned staff
• staff shortages or overages
• staff who have asked to work extra shifts or who are available
• details about staff members’ roles, skills, competencies, costs, overtime
indications, seniority, and current schedule
• flags that indicate when resources are outside safe-staffing parameters
(such as too many hours worked)
• fairness in shift distribution.
The information displayed makes it easier for the manager to design an
effective staffing plan for her unit by giving her the information and resources
she needs to make the best decisions.
Staff nurses at the dashboard
Dashboards can be valuable to staff nurses, too, and can serve as a feeder
system to the manager’s dashboard. Imagine a per-diem nurse planning her
work week at her home computer. Seeking to pick up a shift, she has two
open times that might fit into the unit’s schedule. After logging onto the
appropriate Internet page and opening the staffing dashboard, she finds a
view of her schedule for the week, which displays the work commitments she
has made. For the days when she hasn’t committed, she spots several work
opportunities for which she’s qualified. She sees shift opportunities for both of
her available time frames and looks further to see which one she prefers. From
the same screen, she can see how close she is to meeting her per-diem
commitments for the pay period. She realizes that picking up a shift for both
of her open times is feasible and would allow her to meet the minimum
commitment. She selects these shifts and logs off.
Courtesy of iDashboards® 2010
dures, legislation (such as staffing
ratios, which are defined by law in
California), and labor contract requirements.
Making data available
Making data available is perhaps the
single greatest challenge. The types
of data identified above may reside
in the information systems of various
departments, such as finance, human
resources, payroll, and admission/
discharge/transfer, as well as in various
acuity or patient classification
systems or clinical documentation
systems. These systems may be electronic,
paper-based, or a combination.
Few of them share data easily;
even when they do, the timing of
data entry and availability and consistency
of the data may be problematic.
For instance, if the data
needed to make daily staffing decisions
are available only weekly or
monthly, they aren’t terribly useful.
Challenges also may stem from inconsistent
or poorly understood data
definitions, which can raise doubts
about data validity and make it difficult
to effectively analyze and compare
data sets. (See Using a digital
staffing dashboard.)
Dashboard design and usability
Dashboards provide access to the
disparate data sources needed to
support excellent staffing practices.
Whether you develop your own
dashboard, work with a company
that specializes in developing them,
or use a dashboard provided by
your current staffing system provider,
be aware of the design considerations
that can yield maximum
benefit. For instance, choosing
which data to display can be challenging.
Remember—the more complicated
the dashboard, the less usable
it becomes.
Stay focused on the specific needs
the dashboard is meant to address.
Gaining a deep understanding of the
situation the dashboard is supporting
will help reveal the most critical data
elements.
www.AmericanNurseToday.com May 2010 American Nurse Today 53

Use of color and display options, such as charts and
graphs, can increase a dashboard’s usability. Ideally,
these elements should be user-configurable, as people
differ in how they like to view information. To see the
range of personalization options in a popular webbased
application, visit www.iGoogle.com. This page
allows you to create your own customized homepage
from a menu of options in about 30 seconds.
When designed well, dashboards simplify complex
data, making them more useful. Dashboard designs
that emphasize simplicity and usability while supporting
user configurability are more likely to be used
successfully. User-centered design and design flexibility
are crucial.
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Getting there
Getting the data required for effective, evidencedriven
staffing poses challenges—and in some cases,
it might even be easier to avoid using critical
data when making staffing decisions. But the era of
making these decisions based on tradition or budgets
alone must give way to a process grounded in
an evidence-based model based on meaningful use
of data.
If dashboards are to be all they can be, organizations
must demand that vendors cooperate and collaborate
in defining and using data, as well as in
transferring data from one system to another to meet
organizational requirements. Organizations also need
to find ways to make data more consistent—not just
for their own employees but to support national
benchmarking efforts and identify best practices. ✯
Selected references
Ciesielski S, Daily B, Levine WC. Patient Safety and Quality Healthcare.
A dashboard for the PACU. September/October 2008.
www.psqh.com/sepoct08/pacu.html. Accessed March 24, 2010.
Douglas K, Kerfoot K. Applying a systems thinking model for effective
staffing. Nurse Leader. 2008;6(5):52-55.
Hughes NJ. Clinical dashboards and open kimonos. BMJ. 2008;337:a787.
Hyun S, Bakken S, Douglas K, Stone P. Evidence-based staffing: potential
roles for informatics. Nurs Econ. 2008;26(3):151-158, 173.
Srinivasan A, Abellera JP, Danos S, McNabb S. Improving awareness in
message exchanging platform—a knowledge driven approach. AMIA
Annu Symp Proc. 2007 Oct 11:1122.
St. Joseph Mercy Hospital to install LiveData OR-Dashboard. Business
Wire. June 26, 2007.
Wolpin S. An exploratory study of an intranet dashboard in a multi-state
healthcare system. Stud Health Technol Inform. 2006;122:75-79.
Kathy Douglas is president of the Institute for Staffing Excellence and Innovation in
Sedona, Arizona and former chief nursing officer at Concerro, Inc. in San Diego,
California, a firm that specializes in scheduling and shift-management systems.
✓
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