How You Can Create Your Own Total Knee Replacement Dashboard

It's Easier Than You Think

Creating a clinical dashboard is easier than you think – and with this template and tips you’ll be on your way to having a dashboard in no time.

Quick Tips to Get You Started

First, you need the design for the Total Knee Replacement (TKR) Dashboard. Download it here in excel format.

Second, you need to remember three “truths” about quality data.

  • Truth #1: You already have a gold mine of data that can fuel your improvement efforts for years. The existing databases in your organization are 90% of what you need. A cost accounting system is best, or you can use your finance system.
  • Truth #2: You likely have the in-house expertise to produce your dashboards. The analysts are in your organization, most likely in your accounting or finance department.
  • Truth #3: You can produce most of the quality reports you need without spending a fortune – using your own data and analysts in your organization – and without the expensive third party.

5 Reasons You Need a TKR Dashboard

So, why do you need a TKR dashboard? Here are some great reasons:

  • It’s key to managing your hospital’s and physician’s performance,
  • TKR a high volume procedure and now part of Medicare’s mandatory bundled payment in almost 70 regions in the US,
  • ProPublica’s Surgeon Scorecard has posted your surgeons’ TKR complication rates on the web for everyone to see,
  • Your TKR performance is also reported on the web by Healthgrades and it’s included in Truven’s ratings too, and
  • This dashboard also helps you manage costs – remember, each complication adds $8,000 – $10,000 in additional costs to a patient’s hospitalization. Remove just one complication = save $8,000 to $10,000.

The #1 Goal

The goal for your dashboards is to tell the entire clinical story about your patients’ experience so that you, your physicians, and nurses can evaluate their entire performance.

Let’s take a look each section of the dashboard

Process Measures—Are We Practicing Evidence-Based Medicine?

process measures

Process measures tell you about the process of care—the drugs, treatments and interventions selected by the physicians. Drugs are straightforward. Examples of interventions include blood transfusions, mechanical methods of deep-vein thrombosis (DVT) prevention, or passive range of motion devices.

This process measures section tells you if your physicians are practicing according to the current evidence base in medicine. For example, are they using indicated medications and avoiding contraindicated medications. It also tells you if they are using certain interventions at an appropriate rate for the particular procedure, for example, perhaps only 15% of your patients should receive a blood transfusion. These measures can tie directly to your order sets since they are the embodiment of evidence-based medicine.

All of these measures can be extracted from your organizations finance system or cost accounting system. That’s because each drug or intervention creates a charge that is captured in these databases.

Outcome Measures—What Clinical Outcomes Are Our Patient’s Experiencing?

outcome measures

The Merriam-Webster dictionary defines outcome as: something that happens as a result of an activity or process, or something that follows as a result or consequence.

For our purpose, an outcome is something that happens as a result of the care process. Outcome measures (all specific to the condition or procedure) include complications, length of stay, mortality rate, readmission rate, cost of care, cost of complications, and functional status.

Common Complications

This section on your dashboard shows the complications that are most common for TKRs. There’s no need to list red herrings here, just the complications that are shown in the literature to be common and potentially preventable.

This TKR dashboard also has a measure entitled, “Healthgrades Complications.” This is a composite measure of the complications Healthgrades uses in their rating algorithms. It’s helpful for benchmarking your performance to all of the hospitals in the country that are in the Healthgrades database. It’s also very useful for matching your performance to your star ratings. It can help you move from a one-star to a three-star rating, or when you’re at five-star ratings and want to maintain that level of performance.

Here’s The Bottom Line

  1. You can produce unlimited clinical dashboards using existing databases in your organization.
  1. It requires one or two analysts who are experts in your cost accounting system.
  1. As an example, in my last position, three analysts produced more than 40 dashboards for 15+ hospitals. All were designed, created and produced using internal databases and existing staff. That’s cost effective and I know you can do it too!