In this Clinical Dashboard interview, Skilled Nursing News talks with Lana Blagg, Senior Vice President of Clinical Services at Touchstone Communities, on her wishes for the ideal Clinical Dashboard. Working at Touchstone since 2008 and having previously worked at multiple care centers, Blagg offers her advice on what she would like to see in her Clinical Dashboard — from minimizing risks to reducing duplication of data, improving communication among staff, and more.
What are the three most important data points that you would want to see each day on your ideal clinical dashboard and why?
My ideal clinical dashboard, as far as a DNS would be the top three high risk areas that require immediate attention, oversight, and follow up. These three areas are high risk for regulatory and litigation implications. Risk Management such as falls, indicating those with significant injury (altered mental or consciousness changes, signs and symptoms of dislocation, head injury, lacerations, repeat falls (2 or more falls within last 3 months)), as well as burns, resident-to-resident aggression and choking events. SBARs/Change in conditions and clinical alerts such as poor meal intake less than 25%, weight loss, decline in functioning / required more assistance than usual, pain triggered at 7 or higher and pain triggered without effective relief noted and new wound/PUI or wounds that have deteriorated, as well as medications not available to be administered. At risk for hospitalization (clinical concern identified, medical diagnosis and last hospital stay (within the last 30 days), discharges to the hospital, unplanned discharges, and AMAs.
How would the ideal clinical dashboard drive patient care decisions?
The information pulled from the EHR (Electronic Health Record) to a clinical dashboard could be used for shift-to-shift nursing reports as well as clinical leadership’s clinical review, which could allow the nurses to identify those who should have increased medical and nursing monitoring and interventions in place.
How would the ideal clinical dashboard help optimize reimbursement?
Reimbursement would be optimized directly related to the early identification of changes in condition, early implementation of medical interventions, improved documentation and which would ultimately prevent unnecessary hospitalizations.
How can the clinical dashboard improve staffing efficiency?
Pushing this information to the dashboard will allow the nurses to readily identify and prioritize needs, follow-up and delivery of necessary care and services. This is especially important with the staffing challenges that our industry is facing, meaning this dashboard could serve as the shift-to-shift 24hr nursing report, which could reduce the time the nurse spends on reviewing the chart as well as reducing the time spent typing or writing the same information on the 24-hour report.
How would you like to see the clinical dashboard integrated with predictive analytics tools?
The predictive analytic tools could be used to identify those who are at risk for certain areas and then identify the resident when documentation is condition has changed or clinical alerts are triggered to increase the resident’s risk. For example, a resident is noted to be at risk for falls, a fall has been experienced within the last three months, then a clinical alert of poor appetite or weight loss has been identified, the dashboard could highlight the resident to show that the risk for negative outcomes is likely. This could improve monitoring and enhance shift to shift communication.
Besides yourself, what are the most important roles in your organization to also have access to the clinical dashboard?
Most importantly the bedside nurses need a clinical dashboard that drives early identification, ease of shift-to-shift reporting and drives documentation. Other roles that should have access are clinical leadership within the community, regional nurses and regional care and reimbursement nurses.
What would you do to improve the collection of patient health data?
Minimize documentation that is repetitive or unnecessary. Reduce the amount of documentation so that quality documentation could be information that should pull and push to other areas.
Can the ideal clinical dashboard help with value-based care?
Yes, especially since the value-based care model is based on clinical outcomes. The outcomes are directly related to the early identification of exceptions or changes and the implementation of appropriate interventions to address the identified need; this will improve clinical outcomes.
Can the clinical dashboard improve care denials from managed care?
Absolutely, denials are typically related to the lack of documentation, so having a process in place to drive documentation will definitely improve denials.
