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Workgroup 5
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Workgroup 5OB
Implementing clinical dashboard
1. Quick and dirty scan on clinical dashboards (what does it entail and intend to do)
Tool to reduce medical error and improve clinical communication. It shows
medication a patient is taking, their vitals, how many people are at the ward, waiting
time, how long patients have been at the ward. These dashboards could be strategic,
monitoring patients and care.
2. What is a system perspective and a professional perspective? How do these explain
the potential reactions of professionals on the implementation of clinical
dashboards?
A system perspective argues that humans will make errors, and the system should be
designed in a way to prevent this/minimize this, e.g. protocols, double-check,
showing medication to patient as a way to check, dangerous pills locked in a
separate jar etc. Uses a root-cause analysis to see what went wrong in the system
that led to the mistakes made.
Patient safety and quality of care are an organizational effort instead of just with
individual doctors. A professional perspective argues that it is all about the
professional, they give the care, its their personal responsibility. It’s part of their
education and professional identity, and this occurred because of the want for
autonomy, complexity of care (protocols too strict), implicit/tacit
knowledge/experience which is hard to access for the system perspective, variability
in practice. The professional perspective thusly comes from a different viewpoint
and different reasons, as mentioned above.
Professionals might not like clinical dashboards, as it is more administrative work
which takes away their time with the patients. Also, managers can use it to
benchmark professionals and control them. However, professionals can choose
which indicators are on the dashboards, which will help them in their work and make
them more acceptable to these dashboards. Can go both ways. The way the
dashboards are introduced and framed will have a big impact on how it is received.
3. How are professional autonomy and professional discretion affected by the
implementation of clinical dashboards? (van de Veen, 2013)
Professional discretion: every time there are rules, you have some room to
maneuver in these rules. The ability to make your own choices with these rules is
discretion.
Professional autonomy: professionals decide whether they even want to use any of
the rules. Much broader.
If the dashboards are used to better one’s work, it’s less worse for the professionals.
If they are used to control the professionals, it will limit their autonomy.
Paradox: managers use the professionals’ own tools to control them. Part of being a
professional is making your own quality indicators to have internal control over your
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