Top lessons from creating a whole system safety dashboard in Salford

In this guest blog, Senior Improvement Advisor Bob Diepeveen discusses his top four lessons learnt from creating a whole system dashboard for the Safer Intelligence workstream of the Safer Salford programme.

As part of the Safer Salford work, Haelo (now amalgamated with Aqua) co-created a safety dashboard with local partners in Salford to show the safety of the whole health and care economy for Salford residents. We’ve been guided in our work by the use of the Measurement and Monitoring of Safety framework. I’d like to share some lessons I have learned along the way through the development of the Safer Salford Intelligence Dashboard.

1. Creating a dashboard for a full health and care economy is incredibly challenging
   In Salford we’re blessed with strong links between all the health partners have, for instance through the Salford Together partnership. Working together across sectors has become normal in Salford over the years. Bringing clinicians, leaders, administrators and commissioners together to openly discuss how to measure safety was easier than expected. We still had to deal with the usual time pressures and planning difficulties, but when we got the stakeholders together they openly shared their ideas and concerns. And ideas and concerns they had. We explored many data systems and measures already active in Salford, with every additional expert we talked to the options became numerous. We’ve reviewed over 200 different measures. Only ruthless prioritisation with criteria like: does the measure reflect safety of the provided service? helped us move forward. Not an easy task. We also discovered that some additional non-existing measures were needed to be developed as not all relevant safety information is currently captured. Setting up these new measures takes a lot of time, making sure they are used in a timely and appropriate manner is still ongoing.
2. Don’t be afraid to go back to the drawing board
   We changed the content and the design of the dashboard numerous times; sometimes to stay true to the measurement and monitoring of safety framework, other times to align more with clinical practice. Only through charting the data, sharing them in the designed format and have conversations about them, people were able to see what the end result would look like. From that point forward the development picked up speed and constructive conversations took place. Changing our initial design completely, was paramount in achieving the acceptance of the dashboard we now have.
3. Safety is viewed differently
   At the first development workshop leaders from the different health and care organisations came together and we asked them to grade their safety maturity. This measure has now become one of the measures on the dashboard. The discussion that followed highlighted that a safe delivery of care and evidencing a safe delivery is viewed differently across the sectors. A controllable hospital environment, a harbour to deliver safe care, is different from a less controllable home environment. The systems and processes to create a safe system are therefore also different. For the dashboard it meant there was no one size fits all approach. We had to include some sector specific measures.
4. What is a dashboard?
   The word dashboard is a word that people already have many associations with. All based on previous examples they’ve come across in their life. And most of them are not at all like the dashboard we were developing. Dashboards people know can range from a table with numbers, to a more graphical one, to a full interactive one. Our dashboard was going to be a full interactive one, so visually different from most dashboards people have experienced. On top of that, the use/aim for the Safer Intelligence dashboard is also different from your standard dashboard. Most dashboards are made for assurance, to show if the performance is conform expectations. The Safer Intelligence dashboard is a dashboard primarily made for enquiry: Inviting people to look at the data, start exploring, ask questions, combine information from multiple graphs, think of other data sources that might add to the learning, looking at past, present and future data. So for users to get to know the dashboard requires a lot of time and explaining.

Please take a look at the dashboard. Let us know if you’ve got any questions or other safety dashboards to share. And finally if you need help creating a (safety) dashboard in your organisation or health and care economy please get in touch to explore how we could support you.