Arshad Ali, Chithra Joseph
Measurement is the foundation of quality improvement, yet many neurosurgical departments, particularly those early in their quality journey or with limited informatics resources, lack a structured way to track their performance. Most published neurosurgery dashboards originate from well-resourced academic centers, rely on electronic medical records or business intelligence platforms, and are described only after they have matured. We report the design and implementation, from first principles, of a manually maintained neurosurgery quality dashboard at the Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar, during 2021, at the height of the COVID-19 pandemic. The dashboard was organized into eight quality bundles (Volume, Timely Discharge, Throughput, Service, Clinical Care, Patient Satisfaction, Infection Control, and Patient Safety), each defined in advance by its component indicators, numerator and denominator, data source, and sampling frame. A multidisciplinary team was formed; each bundle was assigned a named frontline owner and a backup; data were collected on standardized spreadsheets, compiled monthly into charts, and reviewed by the team to guide action. We present one year of data as a worked illustration. The dashboard surfaced several actionable signals, including a low rate of discharge before noon, most often attributed to delayed physician orders; episodic transfer-out delays; suboptimal glycemic control; higher physician-domain satisfaction scores in the second half of the year than in the first; consistently high hand-hygiene compliance with no device-related infections; and a low absolute burden of safety events. These observations are descriptive and uncontrolled, were not statistically tested, and are presented to illustrate the dashboard rather than to establish cause or effect. The experience shows that a functional, action-oriented neurosurgery dashboard can be built without advanced informatics when its metrics are clearly defined, its responsibilities are assigned, and its review is disciplined. We offer the eight-bundle structure as a template for departments beginning a quality program, including in resource-limited settings.