Re-formatting layout of ICU List Display.

The addition of an additional two questions to the ICU board meant that the display view was not correctly printing in PDF and the final column, with the all important comments field was missed off the page. Rather than trying to work a whole lot of magic and make the page re-size and print correctly I went for the easy option and have amalgamated the DHB and ICU columns into one in order to pull the comments column back onto the PDF page view.

Whilst this increases the length of the page slightly it was always going to be challenging to fit 25 ICUs on a normal resolution display but over the next couple of weeks I may try and create an alternative display view sized for data projection which will show all ICUs but may need to omit some details like phone, fax and email.

Intensive Care Unit direct dashboard reporting via WebEOC

Over the last week ICU clinical directors and their staff from around the country have been getting used to providing direct local figures for their facility into the DHB Dashboard.

The data fields were developed by an ICU Advisory group representing intensivists and ICU nursing staff from around the country as well as the Ministry. Colin McArthur, Clinical Director from Auckland Department of Critical Care Medicine and the Operations Team in the National Health Coordination Centre were instrumental in supporting the development of this board and persuading users that we could do better than trying to manage 25 excel spreadsheets returned daily.

The ICU dashboard was built as an additional table within the existing DHB Dashboard. This allows a DHB to add as many ICU facilities as they have and then edit and update the records for those ICUs. The previous ICU data that the DHB Emergency Operations Centre had been entering around patients with confirmed H1N1 is now automatically populated via a related list function from the ICU data.

For a DHB with more that one ICU the numbers for each respective category are automatically summed and provided as a return for the DHB. As you can see below the ICU details appear as a nested table within the DHB detail display.

In this case it is Auckland DHB which has a Paediatric ICU (Starship) as well as Cardio Vascular and Department of Critical Care Medicine ICUs. These three ICUs all provide summed figures to the main DHB board.

There is also a display view linked off the main the DHB Dashboard that provides a consolidated view of all of the ICU units. This type of functionality is incredibly useful and the print to PDF button allows a snapshot view to be rapidly disseminated and shared.

It has also been an opportunity to start using some of the built-in reporter functionality of the system, and for the non WebEOC Admins out there this basically allows the admins to build a database query and store it on the control panel as a weblink. Clicking the link will open another window and return the pre-canned report which can then been exported to excel and sliced and diced as required. This is a whole level of functionality we have not really utilised so far but allows historical reports and trends over time to be easily viewed.

For example: Want to see how the incident details board has changed over time? - simply run a report and it will show what time and what user changed any of the specified fields. Of course there are a few limitations, because it is returning raw data fields you need to know what the data fields you are interested in were called and sometimes what was clearly labelled to the developer might not be clear to someone looking at the report later.

Lates updates and changes

The ongoing development of board 47, the DHB Dasboard, including the development of the Intensive Care Unit as well as more consistent reporting via EpiSurv means that board 10 Case Summary has been removed from suers control panels.

We are currently working on an API that will provide a view only display of high level summary data direct from EpiSurv that can displayed on a WebEOC board.

Dashboard displays and WebEOC adaptability

The ongoing response to Novel Influenza A (H1N1) is continuing to generate a lot of new data reporting and collecting requirements at both local and national level EOCs. The big advantage of WebEOC is that these boards to capture and allow local users to directly enter this data (hence reducing errors from transposing results from fax, email, phonecall) can quickly and easily be developed over a couple of hours and then continually be refined. This ongoing board development can even be done, with a bit of care*, on the production database mid incident.

Last week for example Planning and Intelligence in the NHCC identified the need to start to track several disparate pieces of information around hospital admissions and DHB staff sickness for Influenza Like Illness (ILI) and confirmed cases of H1N1. This information was initially gathered as DHB responses to a Task - Request for Information, and then as regular reporting items within their daily sitrep but it made much more sense to collate it into a table, ideally something that would show the status of all 21 DHBs 'at a glance' and perhaps be expandable to track other key indicators as they are identified. In short, for all the WebEOC administrators out there the elusive lesser spotted WebEOC Dashboard.

The actual board was a pretty basic form, that followed the standard CSS formatting of other display pages within our WebEOC board. The initial build was a little clunky:





The 'Current' and 'Cumulative' data fields were recorded above and below each other, however these data fields were sufficient to get the board 'live' and in use at the end of last week.


Following feedback from the sector the categories were extended to capture cases of ILI as well as confirmed H1N1 and two new views were created, one showing current and the other cumulative data with a 'Viewlink' between them in order to streamline the page.


The page also has filter views that allow users to view DHBs data within each of the respective Health Regions. As further categories are identified for this 'Dashboard' additional display views will be created, each accessed by a viewlink button of the main display.

There is some further work to still be done; this board currently requires the DHB to manually indicate whether they have Community Based Assessment Centres open. Now ideally that would be a 'Datalink' from the CBAC status board, but unfortunately that is a 'list' and this is a 'form' display. What that means is there is no easy way of getting rolled up data, such as the number of CBACs open, from the CBAC board to this board. To solve this Jeremy has already mentioned his favourite word, Database Trigger, but in the interim I'm afraid users will need to reconfirm this data in two places. If any WebEOC administrator out there has an idea on a solution to this please PM me.
-------------------------------------------------------------------------------------------------

*I'm talking about adding new fields, adding explanatory text, re-labelling fields or re-arranging display views. I'm not talking about adding complicated java script, building SQL database triggers or anything else you wouldn't find in the plain old vanilla WebEOC Admin manual. Even then I still copy and create a back up of the current view or input that I'm about to mess with!

Shared EOC and Sig Event boards for Ambulance

Two new display boards have been created that allow Ambulance users to view EOC Event data from around the country.

This change was requested because Emergency Ambulance Communications Centre (EACC) was monitoring St John Northern Regions response to the Battle of The Streets last weekend but as everything was going to plan there were very few 'National Sig Events' created and National Sig Events are the EOC log entries which external agencies can see. Now whilst it was clearly a good thing that nothing was 'Nationally Significant' it is often beneficial for agencies to see what is happening routinely . I guess this is human nature, but it also serves to re-assure other agencies that everything is under control and that in fact there are not a whole load of log entries that have been recommended as a "national Sig Event' that the controller has not got around to reviewing and releasing.

We have got around this very quickly by creating 2 new boards; 02a. Ambulance Shared EOC Events and 03a. Ambulance Shared Sig Events. This means that all 10 of the Ambulance regions or structures can view these common logs. Obviously if an emergency occurs at a pre-planned event these logs will quickly grow in size, but at that point agencies should start using the controller reviewing function and posting to the 'National Sig Event' board.

It is important to remember that the Username will indicate the organisation (Ambulance Region) that has posted the entry. but depending on feedback I may add an additional field to the display on these boars to clearly show posting Agency.

I know some agencies in the US have used a slightly different approach whereby they give user access to a 'National Sig Event' board that will filter and show both controller reviewed entries and those awaiting controller review but I think this approach will work equally as well.

At the next meeting of the EMIS reference group we'll discuss whether similar shared Event logs would be useful on a geographical basis for example between groups of District Health Boards (DHBs) in a defined area, or DHBs and their Public Health Units.

Extra fields added to position log

Following feedback from the SuperUser training and discussion at the EMIS Reference Group two additional fields have been added to the generic position log. The priority fields allow users to indicate a Flash, High, Medium or Low priority, whilst the Accuracy field allows them to indicate the level of faith in the data. For example information received from an emergency service or a member of staff on the ground may be rated highly, whilst anecdotal reports may be rated quite low unless corroborating reports are received.

These fields appear above the description in the display view and you can see here two medium priority entries highlighted yellow.

Changes to the Task Summary Display

An extra column has been added to the Task Summary Display on the right hand side. This displays your agency’s response to the task. For example you may have completed your agency response to a task but the task may still be shown as in progress by the agency that created it.