Integration of an Intensive Care Unit Visualization Dashboard (i-Dashboard) as a Platform to Facilitate Multidisciplinary Rounds: Cluster-Randomized Controlled Trial

Chao-Han Lai, Kai-Wen Li, Fang-Wen Hu, Pei-Fang Su, I-Lin Hsu, Min-Hsin Huang, Yen-Ta Huang, Ping-Yen Liu, Meng-Ru Shen, Chao-Han Lai, Kai-Wen Li, Fang-Wen Hu, Pei-Fang Su, I-Lin Hsu, Min-Hsin Huang, Yen-Ta Huang, Ping-Yen Liu, Meng-Ru Shen

Abstract

Background: Multidisciplinary rounds (MDRs) are scheduled, patient-focused communication mechanisms among multidisciplinary providers in the intensive care unit (ICU).

Objective: i-Dashboard is a custom-developed visualization dashboard that supports (1) key information retrieval and reorganization, (2) time-series data, and (3) display on large touch screens during MDRs. This study aimed to evaluate the performance, including the efficiency of prerounding data gathering, communication accuracy, and information exchange, and clinical satisfaction of integrating i-Dashboard as a platform to facilitate MDRs.

Methods: A cluster-randomized controlled trial was performed in 2 surgical ICUs at a university hospital. Study participants included all multidisciplinary care team members. The performance and clinical satisfaction of i-Dashboard during MDRs were compared with those of the established electronic medical record (EMR) through direct observation and questionnaire surveys.

Results: Between April 26 and July 18, 2021, a total of 78 and 91 MDRs were performed with the established EMR and i-Dashboard, respectively. For prerounding data gathering, the median time was 10.4 (IQR 9.1-11.8) and 4.6 (IQR 3.5-5.8) minutes using the established EMR and i-Dashboard (P<.001), respectively. During MDRs, data misrepresentations were significantly less frequent with i-Dashboard (median 0, IQR 0-0) than with the established EMR (4, IQR 3-5; P<.001). Further, effective recommendations were significantly more frequent with i-Dashboard than with the established EMR (P<.001). The questionnaire results revealed that participants favored using i-Dashboard in association with the enhancement of care plan development and team participation during MDRs.

Conclusions: i-Dashboard increases efficiency in data gathering. Displaying i-Dashboard on large touch screens in MDRs may enhance communication accuracy, information exchange, and clinical satisfaction. The design concepts of i-Dashboard may help develop visualization dashboards that are more applicable for ICU MDRs.

Trial registration: ClinicalTrials.gov NCT04845698; https://ichgcp.net/clinical-trials-registry/NCT04845698.

Keywords: Intensive care unit; dashboard; digital health; electronic health record; electronic medical record; i-Dashboard; information exchange; information management strategy; large screen; medical record; multidisciplinary round; visualization dashboard.

Conflict of interest statement

Conflicts of Interest: None declared.

©Chao-Han Lai, Kai-Wen Li, Fang-Wen Hu, Pei-Fang Su, I-Lin Hsu, Min‑Hsin Huang, Yen‑Ta Huang, Ping-Yen Liu, Meng-Ru Shen. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 13.05.2022.

Figures

Figure 1
Figure 1
Transfer of the IntelliSpace Critical Care & Anesthesia information system (ICCA), Hospital Information System (HIS), and Laboratory Information System (LIS) data to i-Dashboard. ETL: Extract-Transform-Load. PaaS: Platform as a Service. WISE-PaaS 4.0: brand name of the platform belonging to Advantech.
Figure 2
Figure 2
i-Dashboard as a platform to facilitate multidisciplinary rounds. (A) Data access through i-Dashboard on different devices (eg, desktop computers and mobile platforms). (B) i-Dashboard displayed on wall-mounted large touch screens as a visualization aid during multidisciplinary rounds.
Figure 3
Figure 3
Study flowchart. EMR: electronic medical record, MDR: multidisciplinary round.

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