Implementing an EHR-Integrated Quality and Safety Dashboard to Improve Inpatient Safety: Clinical Usage and Preliminary Outcomes

Background: Data driven tools are increasingly used to support patient safety and quality improvement, yet evidence on the impact of integrated quality and safety dashboards remains limited. Methods: We conducted a pre to post implementation study using interrupted time series analysis to evaluate the impact of an EHR-integrated quality and safety dashboard on clinical processes and patient outcomes, among three general medicine units at a 171-bed community teaching hospital. All adult patients admitted during seven-month pre- and post-implementation periods were included. The primary outcome was the proportion of hospitalizations with at least one adverse event. Secondary and exploratory outcomes included hospital-acquired conditions, adherence to safety-related process measures, and dashboard utilization. Results: A total of 9,023 hospitalizations were included (4,640 pre-implementation; 4,383 post-implementation). The proportion of hospitalizations with at least one adverse event was similar pre-implementation (23.15%; 95% CI, 20.96 to 25.29) and post-implementation (22.97%; 95% CI, 20.86 to 25.23). CLABSI per 100 patient-days was reduced (aOR 0.47, 95% CI [0.37 to 0.60]); and exploratory analyses demonstrated decreases in slope for post-discharge venous thromboembolism (aOR, 0.66; 95% CI, 0.48 to 0.91; p=0.01) and hospital-acquired pressure injury (aOR, 0.69; 95% CI, 0.48 to 1.00; p=0.05). Several process measures improved, including code status confirmation, venous thromboembolism prophylaxis, delirium screening, chlorhexidine bathing, and fall precautions. Conclusions: Implementation of an EHR-integrated quality and safety dashboard was associated with meaningful improvements in multiple care processes and CLABSI but not overall adverse events. These findings highlight the potential of workflow-integrated dashboards to support frontline quality improvement, while underscoring the need for additional measures to improve clinical outcomes.

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Publication Details

Journal
medRxiv
Published
2026-10-28
DOI
https://doi.org/10.64898/2026.10.26.26366493
Primary Topic
Electronic Health Records Systems
Type
preprint
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preprint

Implementing an EHR-Integrated Quality and Safety Dashboard to Improve Inpatient Safety: Clinical Usage and Preliminary Outcomes

Alison Garber, Anuj K. Dalal, Erin O’Fallon, Savanna Plombon et al.
1 links
medRxiv
Electronic Health Records Systems
preprint

Implementing an EHR-Integrated Quality and Safety Dashboard to Improve Inpatient Safety: Clinical Usage and Preliminary Outcomes

Alison Garber, Anuj K. Dalal, Erin O’Fallon, Savanna Plombon, Stuart R. Lipsitz, Marc Philip T. Pimentel, Jeffrey L. Schnipper, Nicholas R. Piniella, Pamela M. Garabedian
preprint en

Abstract

Background: Data driven tools are increasingly used to support patient safety and quality improvement, yet evidence on the impact of integrated quality and safety dashboards remains limited. Methods: We conducted a pre to post implementation study using interrupted time series analysis to evaluate the impact of an EHR-integrated quality and safety dashboard on clinical processes and patient outcomes, among three general medicine units at a 171-bed community teaching hospital. All adult patients admitted during seven-month pre- and post-implementation periods were included. The primary outcome was the proportion of hospitalizations with at least one adverse event. Secondary and exploratory outcomes included hospital-acquired conditions, adherence to safety-related process measures, and dashboard utilization. Results: A total of 9,023 hospitalizations were included (4,640 pre-implementation; 4,383 post-implementation). The proportion of hospitalizations with at least one adverse event was similar pre-implementation (23.15%; 95% CI, 20.96 to 25.29) and post-implementation (22.97%; 95% CI, 20.86 to 25.23). CLABSI per 100 patient-days was reduced (aOR 0.47, 95% CI [0.37 to 0.60]); and exploratory analyses demonstrated decreases in slope for post-discharge venous thromboembolism (aOR, 0.66; 95% CI, 0.48 to 0.91; p=0.01) and hospital-acquired pressure injury (aOR, 0.69; 95% CI, 0.48 to 1.00; p=0.05). Several process measures improved, including code status confirmation, venous thromboembolism prophylaxis, delirium screening, chlorhexidine bathing, and fall precautions. Conclusions: Implementation of an EHR-integrated quality and safety dashboard was associated with meaningful improvements in multiple care processes and CLABSI but not overall adverse events. These findings highlight the potential of workflow-integrated dashboards to support frontline quality improvement, while underscoring the need for additional measures to improve clinical outcomes.

medRxiv
Brigham and Women's Hospital (US), Brigham and Women's Faulkner Hospital (US), Mass General Brigham (US)
Good health and well-being
Electronic Health Records Systems
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