We’re back with another example of our work with interesting and meaningful data challenges. Today, we’re reflecting on a recent webinar and project with University of California San Francisco (UCSF) who leveraged advanced, actionable analytics to make zero harm a true possibility. The blog will follow STAR, our favorite structure for reporting on successes and challenges:

• Situation
• Task
• Action
• Results

Situation

Over the last year, UCSF went through the process of aligning organizational initiatives to their core mission, vision, and values, using a methodology in the form of a pyramid they call “True North”. One of the essential pillars of this pyramid is Quality and Safety, with three central attributes: trust, report, and improve.

The Enterprise Analytics team was faced with a challenge to support quality data automation, normalization, and dissemination to support this pillar and its associated initiatives. Some of the data challenges faced included:

• Lack of holistic performance: Manual data collection from 7 sources & lack of normalization (e.g. counts versus rates)
• Resource skills: Improvement specialists lacked technical skills to extract source system data on their own and often needed IT help
• Data quality: New data sources needed profiling / quality review
• Data governance: Many nursing units were also tracking similar metrics to support our Magnet journey but with varied dimensions

Task

To overcome the data challenges and achieve zero harm and improve clinical outcomes, UCSF set out to implement a comprehensive analytics tool that would provide easy access to data and high visibility of performance to goals. The project’s goal was to provide automated data, actionable reporting, and an easy way to then disseminate that data to users.

Action

In collaboration with multiple operational groups and subject matter experts, UCSF and Prominence created a Qlikview application. Throughout the development lifecycle they had a continued focus on the organization’s “True North” pyramid. They completed intake and gathered business requirements around all sources, established standard data definitions and calculations to reduce variability between units, and designed a data mart and dashboard to provide data refresh automation.

The thoughtfully designed application provides a high-level summary of the two main aspects of Quality and Safety Performance, achieving zero harm and improving clinical outcomes. Visual indicators allow users to quickly see how they are doing on each of the metrics compared to the goal of the organization. Users can navigate to detail tabs to see monthly trends and breakouts to identify areas for improvement and link to other systems to perform chart review for specific events. Lastly, a printable report tab provides units and clinics the ability to view their own data at a glance to print and display.

Result

Through the process of engaging operations and analytics to collaborate on a project to improve data-driven decision making, UCSF reduced harm events by 83 events in FY 2017, exceeding their goal by 10 events. The success continued in FY 2018 when they achieved their goal of having a total of less than 1,003 events in the entire year.

Along the journey, UCSF gained some insight they are using as they move forward and tackle additional strategic data projects:

• Establish standard data definitions and calculations to reduce variability between units
• Display consistencies were crucial to decreasing confusion (e.g. count vs rates, standard timeframes, axis ranges, etc.)
• Allow added time to project when vendor data is new and has not been used before
• Keep it simple — much of development followed this motto to ensure a clean design that told a story through data
• Improvement in data quality & integrity comes through enhanced data collection, review & maintenance process
• Custom mapping is not feasible long term — a one-time mapping was completed for the project, but to ensure continuous mapping, it needed to join in an overall data governance process. This is what the department will be focusing on in the coming fiscal year

Congratulations UCSF!