dashboard:report_2013-2024 [DocuNeo]

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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 =====

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  "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 =====

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  "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 =====

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  "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 =====

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  "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)**