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--- dashboard:report_2013-2024 [2025/07/02 20:22] – admin
+++ dashboard:report_2013-2024 [2025/07/02 21:01] (versione attuale) – [Red Zone: Critical Areas (Q4 Performance)] admin
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+====== VON Complete Dashboard 2024 - All Key Performance Measures ======
+===== 📊 Executive Summary - Centro 297 Performance =====
+**Data:** VON Annual Report 2024 | **N = 34 infants** (VLBW ≤1500g or ≤29w6d)
+^ Performance Level ^ Count ^ Metriche ^ Impact ^
+| **🟢 TOP QUARTILE (Q1)** | **8/17** | **47%** | ✅ ECCELLENZA |
+| **🟡 ABOVE MEDIAN** | **4/17** | **24%** | ✅ BUONA |
+| **🟠 BELOW MEDIAN** | **3/17** | **18%** | ⚠️ ATTENZIONE |
+| **🔴 BOTTOM QUARTILE (Q4)** | **2/17** | **12%** | 🚨 CRITICA |
+**🎯 POSIZIONAMENTO GENERALE:** **Top Performer** VON Network (71% metriche sopra mediana)
+---
+/* 1. MORTALITY & MAJOR MORBIDITY - Control Chart \*
+===== 📈 Primary Outcomes - Mortality Composite =====
+<achart>
+{
+  "chart": {
+    "type": "bar",
+    "height": 450,
+    "background": "#fafafa"
+  },
+  "title": {
+    "text": "Mortality & Major Morbidity - Centro 297 vs VON Network",
+    "align": "center",
+    "style": { "fontSize": "16px", "fontWeight": "bold" }
+  },
+  "subtitle": {
+    "text": "Lower values = Better performance • 2024 Data",
+    "align": "center"
+  },
+  "series": [
+    {
+      "name": "🏥 Centro 297",
+      "data": [2.9, 2.9, 35.3, 5.9, 14.7]
+    },
+    {
+      "name": "📊 VON Network",
+      "data": [16.0, 11.1, 45.8, 11.5, 5.6]
+    },
+    {
+      "name": "🎯 VON Median",
+      "data": [13.9, 9.0, 41.2, 8.2, 3.4]
+    },
+    {
+      "name": "🔵 Q1 (Top 25%)",
+      "data": [8.3, 4.5, 29.4, 1.2, 0.0]
+    }
+  ],
+  "xaxis": {
+    "categories": [
+      "Mortality",
+      "Mortality Excl Early",
+      "Death or Morbidity",
+      "Any Late Infection",
+      "Necrotizing Enterocolitis"
+    ],
+    "labels": {
+      "rotate": -45,
+      "style": { "fontSize": "11px" }
+    }
+  },
+  "yaxis": {
+    "title": { "text": "Percentage (%)" }
+  },
+  "colors": ["#DC3545", "#6C757D", "#28A745", "#0066CC"],
+  "dataLabels": {
+    "enabled": true,
+    "style": { "fontSize": "10px", "fontWeight": "bold" }
+  },
+  "plotOptions": {
+    "bar": {
+      "columnWidth": "75%"
+    }
+  }
+}
+</achart>
+==== Mortality & Morbidity Analysis ====
+^ Metrica ^ Centro 297 (%) ^ VON Median (%) ^ Quartile ^ Gap ^ Performance ^
+| **Mortality** | 2.9 | 13.9 | 🟢 **Q1** | **-11.0** | ✅ ECCELLENTE |
+| **Mortality Excluding Early** | 2.9 | 9.0 | 🟢 **Q1** | **-6.1** | ✅ ECCELLENTE |
+| **Death or Morbidity** | 35.3 | 41.2 | 🟡 Q1-Q2 | **-5.9** | ✅ BUONA |
+| **Any Late Infection** | 5.9 | 8.2 | 🟡 Q1-Q2 | **-2.3** | ✅ BUONA |
+| **Necrotizing Enterocolitis** | 14.7 | 3.4 | 🔴 **Q4** | **+11.3** | 🚨 CRITICA |
+---
+/*2. ORGAN-SPECIFIC MORBIDITIES - Control Chart \*
+===== 📈 Neurological, Pulmonary & Ocular Outcomes =====
+<achart>
+{
+  "chart": {
+    "type": "line",
+    "height": 450,
+    "background": "#fafafa"
+  },
+  "title": {
+    "text": "Organ-Specific Morbidities - Centro 297 Performance",
+    "align": "center"
+  },
+  "subtitle": {
+    "text": "2024 vs VON Network Benchmarks",
+    "align": "center"
+  },
+  "series": [
+    {
+      "name": "🏥 Centro 297",
+      "data": [11.1, 11.8, 5.9, 0.0, 0.0],
+      "color": "#DC3545"
+    },
+    {
+      "name": "🎯 VON Median",
+      "data": [23.1, 2.9, 6.0, 0.0, 2.6],
+      "color": "#28A745"
+    },
+    {
+      "name": "🔵 Q1 Target",
+      "data": [11.1, 0.0, 0.0, 0.0, 0.0],
+      "color": "#0066CC"
+    },
+    {
+      "name": "🔴 Q3 Limit",
+      "data": [36.4, 5.8, 10.2, 3.2, 7.5],
+      "color": "#FF6B6B"
+    }
+  ],
+  "xaxis": {
+    "categories": [
+      "Chronic Lung Disease",
+      "Pneumothorax",
+      "Severe IVH",
+      "Cystic PVL",
+      "Severe ROP"
+    ],
+    "labels": {
+      "rotate": -45,
+      "style": { "fontSize": "11px" }
+    }
+  },
+  "yaxis": {
+    "title": { "text": "Percentage (%)" },
+    "min": 0,
+    "max": 40
+  },
+  "markers": {
+    "size": [8, 6, 4, 4]
+  },
+  "stroke": {
+    "width": [4, 3, 2, 2],
+    "dashArray": [0, 0, 5, 3]
+  },
+  "annotations": {
+    "points": [
+      {
+        "x": 1,
+        "y": 11.8,
+        "marker": {
+          "size": 10,
+          "fillColor": "#FF0000"
+        },
+        "label": {
+          "text": "CRITICAL",
+          "style": { "color": "#fff", "background": "#FF0000" }
+        }
+      }
+    ]
+  }
+}
+</achart>
+==== Organ-Specific Morbidity Analysis ====
+^ Metrica ^ Centro 297 (%) ^ VON Median (%) ^ Quartile ^ O-E ^ Performance ^
+| **Chronic Lung Disease <33w** | 11.1 | 23.1 | 🟢 **Q1** | -1 | ✅ ECCELLENTE |
+| **Pneumothorax** | 11.8 | 2.9 | 🔴 **Q4** | 0 | 🚨 CRITICA |
+| **Severe IVH** | 5.9 | 6.0 | 🟡 Q1-Q2 | 0 | ✅ BUONA |
+| **Cystic PVL** | 0.0 | 0.0 | 🟢 **Q1** | 0 | ✅ ECCELLENTE |
+| **Severe ROP** | 0.0 | 2.6 | 🟢 **Q1** | 0 | ✅ ECCELLENTE |
+---
+/* 3. DISCHARGE OUTCOMES & GROWTH - Control Chart \*
+===== 📈 Discharge Quality & Growth Parameters =====
+<achart>
+{
+  "chart": {
+    "type": "radar",
+    "height": 450
+  },
+  "title": {
+    "text": "Discharge Outcomes Quality - Centro 297 vs Network",
+    "align": "center"
+  },
+  "series": [
+    {
+      "name": "Centro 297 (Actual)",
+      "data": [61.3, 100, 100, 71.4, 96.4, 85.7, 57.1]
+    },
+    {
+      "name": "VON Median (Target)",
+      "data": [63.0, 95.1, 95.5, 72.7, 88.1, 70.0, 69.6]
+    },
+    {
+      "name": "Q1 Excellence",
+      "data": [50.0, 100, 100, 81.1, 95.0, 80.0, 60.0]
+    }
+  ],
+  "xaxis": {
+    "categories": [
+      "Any Human Milk %",
+      "No Oxygen %",
+      "No Monitor %",
+      "Weight >3rd %",
+      "Head Circ >3rd %",
+      "Weight >10th %",
+      "Head Circ >10th %"
+    ]
+  },
+  "yaxis": {
+    "min": 0,
+    "max": 100
+  },
+  "colors": ["#DC3545", "#28A745", "#0066CC"],
+  "markers": {
+    "size": 6
+  },
+  "legend": {
+    "position": "top"
+  }
+}
+</achart>
+==== Discharge Quality Metrics ====
+^ Metrica ^ Centro 297 (%) ^ VON Median (%) ^ Quartile ^ Target ^ Performance ^
+| **Any Human Milk** | 61.3 | 63.0 | 🟡 Q1-Q2 | >50% | ✅ BUONA |
+| **Oxygen at Discharge** | 0.0 | 4.9 | 🟢 **Q1** | 0% | ✅ ECCELLENTE |
+| **Monitor at Discharge** | 0.0 | 4.5 | 🟢 **Q1** | 0% | ✅ ECCELLENTE |
+| **Discharge Weight >3rd** | 71.4 | 72.7 | 🟡 Q2-Q3 | >70% | ✅ BUONA |
+| **Head Circumference >3rd** | 96.4 | 88.1 | 🟢 **Q1** | >80% | ✅ ECCELLENTE |
+| **Discharge Weight >10th** | 57.1 | 50.0 | 🟡 Q1-Q2 | >50% | ✅ BUONA |
+| **Head Circumference >10th** | 85.7 | 69.6 | 🟢 **Q1** | >70% | ✅ ECCELLENTE |
+---
+/* 4. LENGTH OF STAY ANALYSIS \*
+===== 📊 Efficiency Metrics - Days to Disposition =====
+<achart>
+{
+  "chart": {
+    "type": "column",
+    "height": 400
+  },
+  "title": {
+    "text": "Length of Stay Comparison - Centro 297 vs Network",
+    "align": "center"
+  },
+  "series": [
+    {
+      "name": "Centro 297 (Days)",
+      "data": [57, 44, 7, 55]
+    },
+    {
+      "name": "VON Median (Days)",
+      "data": [70, 49, 13, 59]
+    },
+    {
+      "name": "Q1 Best Performance",
+      "data": [62, 38, 7, 52]
+    }
+  ],
+  "xaxis": {
+    "categories": ["Home", "Transfer", "Died", "All Cases"],
+    "title": { "text": "Disposition Type" }
+  },
+  "yaxis": {
+    "title": { "text": "Mean Days" }
+  },
+  "colors": ["#DC3545", "#28A745", "#0066CC"],
+  "dataLabels": {
+    "enabled": true,
+    "style": { "fontWeight": "bold" }
+  }
+}
+</achart>
+**📊 Length of Stay Performance:**
+- **Home:** 57 days vs 70 median (**-13 days** - MIGLIORE)
+- **Transfer:** 44 days vs 49 median (**-5 days** - MIGLIORE)
+- **Overall:** 55 days vs 59 median (**-4 days** - EFFICIENTE)
+---
+/* 5. COMPREHENSIVE SCORECARD \*
+===== 🎯 Complete Performance Matrix - All 17 Measures =====
+==== Green Zone: Excellence (Q1 Performance) ====
+^ Metrica ^ Centro 297 ^ VON Q1 ^ Status ^ Maintained Since ^
+| **Mortality** | 2.9% | ≤8.3% | ✅ **TOP 25%** | 2024 breakthrough |
+| **Mortality Excluding Early** | 2.9% | ≤4.5% | ✅ **TOP 25%** | 2024 breakthrough |
+| **Chronic Lung Disease** | 11.1% | ≤11.1% | ✅ **TOP 25%** | 2024 recovery |
+| **Cystic PVL** | 0.0% | ≤0.0% | ✅ **TOP 25%** | Consistently excellent |
+| **Severe ROP** | 0.0% | ≤0.0% | ✅ **TOP 25%** | Consistently excellent |
+| **Oxygen at Discharge** | 0.0% | ≤0.0% | ✅ **TOP 25%** | Consistently excellent |
+| **Monitor at Discharge** | 0.0% | ≤0.0% | ✅ **TOP 25%** | Consistently excellent |
+| **Head Circumference >3rd** | 96.4% | ≥95.0% | ✅ **TOP 25%** | Growth excellence |
+==== Yellow Zone: Above Median (Q1-Q2 Performance) ====
+^ Metrica ^ Centro 297 ^ VON Median ^ Gap ^ Trend ^
+| **Death or Morbidity** | 35.3% | 41.2% | **-5.9** | ✅ Better than median |
+| **Any Late Infection** | 5.9% | 8.2% | **-2.3** | ✅ Better than median |
+| **Severe IVH** | 5.9% | 6.0% | **-0.1** | ✅ At median |
+| **Any Human Milk** | 61.3% | 63.0% | **-1.7** | ⚠️ Slightly below |
+==== Orange Zone: Below Median (Q2-Q3 Performance) ====
+^ Metrica ^ Centro 297 ^ VON Median ^ Gap ^ Action Needed ^
+| **Discharge Weight >3rd** | 71.4% | 72.7% | **-1.3** | 🟡 Minor concern |
+| **Discharge Weight >10th** | 57.1% | 50.0% | **+7.1** | ✅ Actually good |
+| **Head Circumference >10th** | 85.7% | 69.6% | **+16.1** | ✅ Actually excellent |
+==== Red Zone: Critical Areas (Q4 Performance) ====
+^ Metrica ^ Centro 297 ^ VON Median ^ Gap ^ Priority ^
+| **Necrotizing Enterocolitis** | 14.7% | 3.4% | **+11.3** | 🚨 **URGENT** |
+| **Pneumothorax** | 11.8% | 2.9% | **+8.9** | 🚨 **HIGH** |
+---
+/*6. STRATEGIC DASHBOARD & ACTION PLAN\*
+===== 🎯 2025 Strategic Priorities =====
+==== Priority 1: Critical Issues Resolution (Q1 2025) ====
+**🚨 NECROTIZING ENTEROCOLITIS - Immediate Action**
+- **Current:** 14.7% vs 3.4% VON (Q4 - Bottom 25%)
+- **Target:** <7% by Q2 2025 (move to Q2-Q3)
+- **Actions:**
+  - [ ] Emergency review feeding protocols
+  - [ ] Audit antibiotic prophylaxis guidelines
+  - [ ] Staff retraining on early recognition
+  - [ ] Weekly case reviews for 6 months
+**⚠️ PNEUMOTHORAX - Protocol Review**
+- **Current:** 11.8% vs 2.9% VON (Q4 - Bottom 25%)
+- **Target:** <6% by Q3 2025 (move to Q2-Q3)
+- **Actions:**
+  - [ ] Ventilation strategy review
+  - [ ] Surfactant administration protocols
+  - [ ] Respiratory therapy training update
+==== Priority 2: Excellence Maintenance (Ongoing) ====
+**✅ MORTALITY LEADERSHIP**
+- **Achievement:** Q1 performance in both metrics
+- **Maintain:** Continue protocols that achieved breakthrough
+- **Share:** Document best practices for network
+**✅ CHRONIC LUNG DISEASE RECOVERY**
+- **Achievement:** From Q4 (2023) to Q1 (2024)
+- **Maintain:** Current ventilation strategies
+- **Monitor:** Prevent regression to previous levels
+**✅ DISCHARGE QUALITY**
+- **Achievement:** Q1 in 3/4 discharge metrics
+- **Optimize:** Human milk to reach >65%
+- **Maintain:** Zero oxygen/monitor discharges
+==== Priority 3: Continuous Improvement (2025-2026) ====
+**📈 HUMAN MILK OPTIMIZATION**
+- **Current:** 61.3% vs 63.0% VON
+- **Target:** >70% by end 2025
+- **Strategy:** Leverage existing lactation protocols
+**📊 BENCHMARKING LEADERSHIP**
+- **Goal:** Achieve Q1 performance in >80% metrics
+- **Current:** 47% Q1 performance
+- **Timeline:** 18-month improvement plan
+==== Investment & ROI ====
+^ Priority ^ Investment ^ Timeline ^ Expected ROI ^
+| **NEC Resolution** | €15,000 | 6 months | Move from Q4 to Q2 |
+| **Pneumothorax Protocol** | €8,000 | 9 months | Move from Q4 to Q2 |
+| **Excellence Maintenance** | €5,000 | Ongoing | Maintain Q1 status |
+| **Human Milk Optimization** | €3,000 | 12 months | Reach Q1 performance |
+| **TOTAL** | **€31,000** | **2025** | **Top 10% VON Network** |
+==== Success Metrics 2025 ====
+**Q2 2025 Targets:**
+- ✅ NEC: <7% (from 14.7%)
+- ✅ Pneumothorax: <6% (from 11.8%)
+- ✅ Maintain all current Q1 metrics
+- ✅ Human Milk: >65%
+**Year-End 2025 Goal:**
+- 🎯 **>75% metrics in Q1-Q2** (vs current 71%)
+- 🎯 **Zero Q4 metrics** (vs current 2)
+- 🎯 **VON Network Top 10%** overall ranking
+===== 📊 Quick Reference Performance Card =====
+**🟢 EXCELLENT (8 metrics):** Mortality, CLD, PVL, ROP, Discharge Support, Growth
+**🟡 GOOD (7 metrics):** Morbidity, Infection, IVH, Human Milk, Weights
+**🔴 CRITICAL (2 metrics):** NEC, Pneumothorax
+**Overall Grade: B+ (Excellent with 2 critical areas)**
+**Network Ranking: Estimated Top 25%**
+**2025 Goal: A- (Top 10% with all areas resolved)**