Guan Tiffany K, Willer Brittany L, Stevens Jack, Tobias Joseph D, Olbrecht Vanessa A
College of Medicine, The Ohio State University, Columbus, OH, USA.
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Clinicoecon Outcomes Res. 2024 Dec 7;16:841-845. doi: 10.2147/CEOR.S499363. eCollection 2024.
Identification and reporting of severe adverse events (SAEs) during anesthesia care remains critical in identifying areas of improvement in perioperative patient care. Although many healthcare organizations rely on the self-reporting of SAEs, under-reporting may limit the identification of the true incidence of these events. To circumvent these barriers, many healthcare systems leverage the Electronic Medical Record (EMR) by incorporating an Anesthesia Information Management System (AIMS).
We followed the Institute for Healthcare Improvement's Model of Improvement and implemented behavioral economic-based interventions to our perioperative practice including adding a deliberation-promoting "hard stop" that required the anesthesiologists to report the occurrence or absence of a "notable event" prior to closing a patient's encounter in the EMR system.
At baseline, 53% of SAEs were self-reported. The interventions resulted in a baseline shift to more than 75% self-reporting, a relative increase of 42%.
An increase in reporting of SAEs was achieved with simple interventions including modifications of the EMR which were done with limited financial impact or interruption in the work flow.
麻醉护理期间严重不良事件（SAE）的识别与报告对于确定围手术期患者护理的改进领域仍然至关重要。尽管许多医疗机构依赖SAE的自我报告，但报告不足可能会限制对这些事件真实发生率的识别。为了克服这些障碍，许多医疗系统通过整合麻醉信息管理系统（AIMS）来利用电子病历（EMR）。
我们遵循医疗改进研究所的改进模式，并在围手术期实践中实施基于行为经济学的干预措施，包括添加一个促进深思熟虑的“硬停止”，要求麻醉医生在电子病历系统中结束患者诊疗前报告“显著事件”的发生或未发生情况。
在基线时，53%的SAE是自我报告的。这些干预措施使基线水平转变为超过75%的自我报告，相对增加了42%。
通过包括对电子病历进行修改在内的简单干预措施，实现了SAE报告率的提高，这些措施对财务影响有限，且未中断工作流程。
