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Improving Availability of Key Information During Resuscitations: Implementation of a Large Screen Electronic Dashboard
Andrea Rinderknecht, MD, Mary Frey, MSN, RN, CNL, CPN, CPEN, Michael R. FitzGerald, PhD, Bruce Dellaposta, Ed.D., LSSMBB and Jennifer Oehler, MSN, RN, Cincinnati Children's Hospital Medical Center, Cincinnati OH

Abstract:
Background/Purpose During emergency department (ED) resuscitations, nursing and physician team leaders need access to vital data from various sources to accurately assess critically ill or injured patients and guide clinical decision-making. No system in our ED efficiently displays all data needed to make timely and informed decisions about patient care in this vulnerable population. Methods Through customization of EPIC trauma narrator widgets, we developed a large screen electronic dashboard which displays graphical vital sign trends as well as data around patient demographics, medications, procedures, laboratory and radiographic tests, and video laryngoscope output. The dashboard was tested in the resuscitation area of the ED in a large, tertiary care pediatric hospital. A custom-designed survey was used to assess resuscitation team leaders' perceptions regarding the accessibility of key data both before and after the test system was implemented. Paired-samples t-tests were conducted to compare the mean differences. Results 47% (21/45) of physicians and 48% (12/25) of nurses completed both pre- and post-implementation surveys. There was statistically significant improvement in perceived accessibility for each data type (figure 1), but especially for vital sign trend, time elapsed since medications/procedures, and view of the endotracheal tube passing the cords during intubation. Conclusions The development and implementation of a large screen electronic dashboard significantly improved physician and nursing team leaders' perception of accessibility of key data required during resuscitative care.
Figures:

Objective:
To describe the impact of a large screen electronic dashboard on emergency department physician and nurse resuscitation team leaders' perception of the availability of key data required for patient care and decision-making.Objective Content:
1) A large screen electronic dashboard was developed through customization of EPIC Trauma Narrator widgets and a test system implemented in a single resuscitation bay of a large pediatric emergency department. 2) A custom-designed survey was developed to assess emergency medicine physician and nursing resuscitation team leaders' perceptions of the availability of key data data during a resuscitation, both pre- and post-implementation of the dashboard. Data types included vital sign trends, time since medications were administered, time since the start of the resuscitation, results of laboratory or radiographic studies, and a view of the video laryngoscope feed during intubations. 3) There was a statistically significant improvement in the mean differences of perceived accessibility of all data types with the implementation of the electronic dashboard. The biggest changes in perceived availability were for vital sign trend, time since medication and procedures, and the view of the endotracheal tube going through the cords during intubation.


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