Literature DB >> 22737780

Improving documentation of a beta-blocker quality measure through an anesthesia information management system and real-time notification of documentation errors.

Bala G Nair1, Gene N Peterson, Shu-Fang Newman, Wei-Ying Wu, Vickie Kolios-Morris, Howard A Schwid.   

Abstract

BACKGROUND: Continuation of perioperative beta-blockers for surgical patients who are receiving beta-blockers prior to arrival for surgery is an important quality measure (SCIP-Card-2). For this measure to be considered successful, name, date, and time of the perioperative beta-blocker must be documented. Alternately, if the beta-blocker is not given, the medical reason for not administering must be documented.
METHODS: Before the study was conducted, the institution lacked a highly reliable process to document the date and time of self-administration of beta-blockers prior to hospital admission. Because of this, compliance with the beta-blocker quality measure was poor (-65%). To improve this measure, the anesthesia care team was made responsible for documenting perioperative beta-blockade. Clear documentation guidelines were outlined, and an electronic Anesthesia Information Management System (AIMS) was configured to facilitate complete documentation of the beta-blocker quality measure. In addition, real-time electronic alerts were generated using Smart Anesthesia Messenger (SAM), an internally developed decision-support system, to notify users concerning incomplete beta-blocker documentation.
RESULTS: Weekly compliance for perioperative beta-blocker documentation before the study was 65.8 +/- 16.6%, which served as the baseline value. When the anesthesia care team started documenting perioperative beta-blocker in AIMS, compliance was 60.5 +/- 8.6% (p = .677 as compared with baseline). Electronic alerts with SAM improved documentation compliance to 94.6 +/- 3.5% (p < .001 as compared with baseline).
CONCLUSIONS: To achieve high compliance for the beta-blocker measure, it is essential to (1) clearly assign a medical team to perform beta-blocker documentation and (2) enhance features in the electronic medical systems to alert the user concerning incomplete documentation.

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Year:  2012        PMID: 22737780     DOI: 10.1016/s1553-7250(12)38036-7

Source DB:  PubMed          Journal:  Jt Comm J Qual Patient Saf        ISSN: 1553-7250


  5 in total

1.  Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.

Authors:  Bala G Nair; Katherine Grunzweig; Gene N Peterson; Mayumi Horibe; Moni B Neradilek; Shu-Fang Newman; Gail Van Norman; Howard A Schwid; Wei Hao; Irl B Hirsch; E Patchen Dellinger
Journal:  J Clin Monit Comput       Date:  2015-06-12       Impact factor: 2.502

2.  Near real-time notification of gaps in cuff blood pressure recordings for improved patient monitoring.

Authors:  Bala G Nair; Mayumi Horibe; Shu-Fang Newman; Wei-Ying Wu; Howard A Schwid
Journal:  J Clin Monit Comput       Date:  2013-01-03       Impact factor: 2.502

Review 3.  A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems.

Authors:  Allan F Simpao; Jonathan M Tan; Arul M Lingappan; Jorge A Gálvez; Sherry E Morgan; Michael A Krall
Journal:  J Clin Monit Comput       Date:  2016-08-16       Impact factor: 2.502

Review 4.  Perioperative Information Systems: Opportunities to Improve Delivery of Care and Clinical Outcomes in Cardiac and Vascular Surgery.

Authors:  Robert E Freundlich; Jesse M Ehrenfeld
Journal:  J Cardiothorac Vasc Anesth       Date:  2017-11-04       Impact factor: 2.628

5.  Development and Feasibility of a Real-Time Clinical Decision Support System for Traumatic Brain Injury Anesthesia Care.

Authors:  Taniga Kiatchai; Ashley A Colletti; Vivian H Lyons; Rosemary M Grant; Monica S Vavilala; Bala G Nair
Journal:  Appl Clin Inform       Date:  2017-01-25       Impact factor: 2.342

  5 in total

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