In many cases, healthcare facilities use dashboards to display specific data to help in this process; dashboards allow users to home in on information, frame upcoming conversations, highlight outstanding work, and plan continuous performance improvement.
However, dashboards are often created by non-clinical individuals who may not know the best ways to display data for truly meaningful interpretation. That’s why one acute care, not-for-profit Magnet®-designated hospital in New Jersey implemented a pilot program using individual report cards to help influence staff behavior. The program was described in the March 2021 issue of Nursing Management.
Designing individual report cards for nursing staff
Consistent feedback is important to continued staff performance improvement, but the nurse managers who implemented this pilot program noted that, in many cases, feedback was inconsistent throughout the year. This feedback was often initiated in response to an issue with the individual, or it was generalized based on unit-level data with periodic individual-level data. Additionally, nurse managers varied in their practice of praising nursing staff members or providing them with opportunities to improve.
The pilot program ultimately combined multiple data points to create individual dashboards, or report cards. These one-page documents were populated with personalized administrative and quality data, giving unit supervisors a method of providing a single source of feedback for each staff nurse. Administrative data included factors such as:
- Per diem hours worked
- Rates of tardiness or overtime
- Unscheduled absences
Quality data was customized based on unit initiatives, such as bar code medication verification and pain reassessment rates. After reviewing each report card, nurse managers decided whether any next steps should be taken, such as recognition or coaching. After this review, the report cards were shared with unit supervisors, who discussed them with staff.
Reviews were quick, each lasting only a few minutes unless the staff member initiated a discussion about opportunities for performance improvement. Report cards were provided with the expectation that they would serve as monthly performance indicators, driving content for yearly review.
Improvements in nursing performance measures
The pilot program was conducted across two nursing units, and the following results were noted:
- 12% increase in the communication domain of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) on Unit 1.
- 3% increase in the nurse communication domain on Unit 2.
- 41% reduction in incidental hours on Unit 1, and 32% reduction on Unit 2.
- 11% improvement in quality metrics regarding bar code medication verification rates and pain reassessment rates on Unit 1.
- 8% improvement in quality metrics regarding bar code medication verification rates and pain reassessment rates on Unit 2.
Fostering pride within nursing teams
In addition to the measures above, creating report cards for staff members appeared to foster a team environment and unit cohesion, which drove overall unit performance. Each month, staff nurses were able to “compete” with each other to find ways to improve performance, which helped increase the unit’s sense of pride.
The implications for nurse leaders were clear — unit-level data is extremely relevant to performance improvement, but staff nurses must be able to understand their role in driving this improvement. Using individual data to encourage staff engagement is important, and organizations can use dashboards to accumulate high-level data which can then be disseminated into useful individual information.