Research Article: Automated notifications improve time to anesthesia induction: Integrating health information technology systems to enhance perioperative efficiency

Date Published: October 22, 2018

Publisher:

Author(s): Cindy Yeoh, Jennifer Mascarenhas, Kay See Tan, Luis Tollinche.

http://doi.org/10.15761/JAA.1000116

Abstract

To evaluate the effects of health information technology systems integration on perioperative efficiency by investigating if automated notifications of patient arrival to the operating room leads to decreased time to induction by anesthesiologists.

We performed a retrospective chart review of all outpatient and short-stay patients who received General Anesthesia at our institution between July 1, 2017 and June 30, 2018.

Duration of induction was significantly shorter post-event notification implementation compared to pre-event implementation (median duration, 6 min vs 7 min; p=0.001).

We demonstrate that health information technology systems integration improves perioperative efficiency of anesthesiologists at our institution. Further investigation is warranted to provide data to support provider buy-in and greater uptake and implementation of these systems to enhance patient care and coordination in the healthcare setting.

Partial Text

Health information technology (IT) systems have evolved to highly sophisticated levels in recent years. Coordination of care for patients is imperative in modern medicine, and we can now leverage health IT systems such as the electronic medical record and other patient and provider-centered technologies to improve upon patient care and coordination in our healthcare system.

We performed a retrospective chart review of all outpatient and short-stay patients who received General Anesthesia (GA) at our institution between July 1, 2017 and June 30, 2018. Only first cases of the day for all anesthesiologists were included in this study. Other inclusion criteria were patients over the age of 18 years, with ASA physical status classification of 1–3. ASA 4 and 5 patients were excluded to eliminate the possibility that higher acuity patients may have a longer pre-induction time (“anesthesia start to anesthesia induction time”). Duration between anesthesia start time and initiation of induction was used as a primary measure of efficiency between the two comparison groups.

Through retrospective chart review of electronic patient records, 1579 records matched inclusion criteria of GA cases for patients over 18 years that were first case of the day (all case types for all surgical subspecialties) pre-event notification implementation (N=758) and post-event notification (N=821). Of these, 694 were outpatient versus 885 short stay cases. ASA classifications for all included cases were: ASA 1 (N=31), ASA 2 (N=960), and ASA 3 (N=588).

In our prior studies, we demonstrated that anesthesiologists at our institution with access to RTLS were significantly more efficient in their perioperative workflow (p <0.0001) than those without access to RTLS[12,13]. While recognizing several confounding factors, we concluded that access to RTLS improves perioperative efficiency of anesthesiologists in two ways: 1)It provides OR staff the ability to track the location of an entire OR team, including the patient, in real-time, which may allow for a more efficient process in deeming an OR “ready”.2)The awareness that one is being tracked and monitored may motivate all OR staff, including anesthesiologists, to be readily available once the OR is deemed “ready”[14]. IT systems such as real-time locating and event notification systems hold great promise for enhancing the care and coordination of patients. While these systems are well-developed and widely available for adoption and use, strategies need to be implemented to target non-adopters and late adopters.   Source: http://doi.org/10.15761/JAA.1000116

 

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