Edsall D W
Department of Anesthesiology, Burbank Hospital, Fitchburg, MA 01420.
QRB Qual Rev Bull. 1991 Jun;17(6):182-93. doi: 10.1016/s0097-5990(16)30452-3.
Private practice anesthetists are skeptical about the worth of quality assessment programs because of the difficulty of creating and maintaining an accurate and efficient medical record, the paucity of data caused by the recent shift in emphasis from process to outcome data, the tendency of adverse outcomes to be presented with no denominators, the lack of integration between process and outcome data, and the tendency for quality assessment programs to require duplicate documentation. An efficient anesthesia information management system (AIMS) gathers accurate, complete, and legible information before, during, and after each anesthetic procedure. One such system used in a private practice setting at Burbank Hospital, Fitchburg, Massachusetts, has a computerized data base to draw from preoperative, intraoperative, and postoperative events, with a judicious selection of both process and outcome indicators. The clinical anesthesia data base can be an effective tool for practical and efficient clinical competency evaluations and can lead to many improvements in the quality of anesthesia care delivery.
私人执业麻醉医生对质量评估项目的价值持怀疑态度，原因如下：创建和维护准确且高效的病历存在困难；近期重点从过程数据转向结果数据导致数据匮乏；不良结果往往在没有分母的情况下呈现；过程数据和结果数据缺乏整合；以及质量评估项目倾向于要求重复记录。一个高效的麻醉信息管理系统（AIMS）在每次麻醉手术前、手术中和手术后收集准确、完整且清晰可读的信息。马萨诸塞州菲奇堡市伯班克医院在私人执业环境中使用的一个这样的系统，有一个计算机化数据库，可提取术前、术中和术后事件，并明智地选择过程和结果指标。临床麻醉数据库可以成为进行实用且高效的临床能力评估的有效工具，并能带来麻醉护理质量的诸多改进。
