Implementing an EHR-Integrated Quality and Safety Dashboard to Improve Inpatient Safety: Clinical Usage and Preliminary Outcomes

Abstract

Background: Data driven tools are increasingly used to support patient safety and quality improvement, yet evidence on the impact of integrated quality and safety dashboards remains limited. Methods: We conducted a pre to post implementation study using interrupted time series analysis to evaluate the impact of an EHR-integrated quality and safety dashboard on clinical processes and patient outcomes, among three general medicine units at a 171-bed community teaching hospital. All adult patients admitted during seven-month pre- and post-implementation periods were included. The primary outcome was the proportion of hospitalizations with at least one adverse event. Secondary and exploratory outcomes included hospital-acquired conditions, adherence to safety-related process measures, and dashboard utilization. Results: A total of 9,023 hospitalizations were included (4,640 pre-implementation; 4,383 post-implementation). The proportion of hospitalizations with at least one adverse event was similar pre-implementation (23.15%; 95% CI, 20.96 to 25.29) and post-implementation (22.97%; 95% CI, 20.86 to 25.23). CLABSI per 100 patient-days was reduced (aOR 0.47, 95% CI [0.37 to 0.60]); and exploratory analyses demonstrated decreases in slope for post-discharge venous thromboembolism (aOR, 0.66; 95% CI, 0.48 to 0.91; p=0.01) and hospital-acquired pressure injury (aOR, 0.69; 95% CI, 0.48 to 1.00; p=0.05). Several process measures improved, including code status confirmation, venous thromboembolism prophylaxis, delirium screening, chlorhexidine bathing, and fall precautions. Conclusions: Implementation of an EHR-integrated quality and safety dashboard was associated with meaningful improvements in multiple care processes and CLABSI but not overall adverse events. These findings highlight the potential of workflow-integrated dashboards to support frontline quality improvement, while underscoring the need for additional measures to improve clinical outcomes.