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Red Alerts for Dashboards

Patient Safety Quality Monthly, December 11, 2008

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In a car or an airplane cockpit, the most important information is presented to the driver or pilot right in front of them. In a car, we call this the dashboard—it contains the speedometer, gas gauge, engine temperature, tachometer, and other gauges or warning lights.

In our hospitals or care facilities, many quality departments are developing dashboards for their organization, senior leadership, and the board. Although dashboards are a great idea if implemented correctly, they often become ineffective and sometimes misleading.

As we work with organizations to review their dashboards, one of the first problem areas we notice is the use of the "red alert". You know—all those squares that have turned red. If too many reds stay red too long on your dashboard, you may have fallen into the "cry wolf" syndrome. Soon, no one pays attention and nothing changes—even worse, you start to accept operations as normal even when many areas are in red alert. If we ignore the red warning lights in our car, bad things happen. The same applies to our quality dashboards.

What to do:

1. Select the set points for turning a dashboard indicator red based on an indication of a real, vital problem in the organization. Avoid red set points that are +/– x% from the national average. If your dashboard goes red, you want everyone to know that something is unacceptable.
2. Think about a red alert on your dashboard as the equivalent of a code blue for your organization. Make sure red alerts are vitally important situations that get your leadership's attention.
3. Plan ahead with a response strategy. The most effective dashboards have an accompanying chart with preplanned actions if any of the indicators change. The reason we can respond effectively in a code situation is because we have planned and practiced. Shouldn't we plan what we will do if our infection control indicator goes into red alert?

Your red alerts are perhaps the most important thing on your dashboard. Use them wisely, make sure they communicate the need for immediate action, and plan ahead. This is a key step in making your dashboards work for you.

Ken Rohde

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