An automated critical event screening and notification system to facilitate preanesthesia record review Journal Article


Authors: Wax, D. B.; McCormick, P. J.; Joseph, T. T.; Levin, M. A.
Article Title: An automated critical event screening and notification system to facilitate preanesthesia record review
Abstract: Anesthesia information management systems make prior anesthesia records readily available for review when patients return for a subsequent procedure but may create a problem of too much documentation to review in a limited amount of time. We implemented a screening tool to facilitate the identification of critical documentation for review. METHODS: An algorithm was developed to electronically search prior anesthesia records for predefined critical events and flag records containing these events. Our web-based daily case schedule was modified to contain a warning message for any patient on the schedule who has a prior record flagged by the system, in addition to a preexisting hyperlink to view the relevant record. A retrospective analysis was performed to determine the impact of the warning messages on the frequency with which the care team reviewed these records before providing anesthesia care. RESULTS: The screening algorithm flagged 13% of archived cases as critical. There were 3329 and 3369 cases in the 6 months before and after system implementation, respectively, that had prior critical records available for review at that time. One or more of these critical records were viewed before the subsequent case start in 39% vs 59% (P < 01) of cases in the pre- versus postimplementation periods. Subgroup analysis revealed that the increase was greatest for attending anesthesiologists working alone. CONCLUSIONS: We created a system to automatically detect critical events in prior anesthesia records for the purpose of forewarning the anesthesia care team when the same patient returns for another procedure. Inclusion of these warnings on the daily case schedule was associated with an increased frequency of preanesthesia review of old records. © 2017 International Anesthesia Research Society.
Keywords: adult; controlled study; major clinical study; review; medical record review; retrospective study; anesthesia; human; male; female; anesthesiologist
Journal Title: Anesthesia and Analgesia
Volume: 126
Issue: 2
ISSN: 0003-2999
Publisher: Lippincott Williams & Wilkins  
Date Published: 2018-02-01
Start Page: 606
End Page: 610
Language: English
DOI: 10.1213/ane.0000000000002141
PROVIDER: scopus
PUBMED: 29053113
DOI/URL:
Notes: Review -- Export Date: 4 September 2018 -- Source: Scopus
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