Creating Quality-Driven Operational Reports

1. Creating Quality-DrivenOperational Reports David Sinclair MD Associate Professor of Clinical Anesthesiology Associate Chief of Anesthesiology Co-Director of Informatics Epic UChart Physician Champion

3. Toyota Advanced Quality Information Center “…a multimillion dollarcomputer system manned by 20 employees who compile repair reports from Toyota dealerships world-wide…and will be accessible on an as-needed basis.” Chester Dawson and Yoshio Takahashi, “Toyota Makes New Push to Avoid Recalls,” The Wall Street Journal, February 24, 2011

5. Improving Quality Through Meaningful Use

7. Can AIMS Deliver?

10. Quality of Care EMR

11. Electronic Medical Record Pitfalls Gill, J. M. EMRs for improving quality of care: promise and pitfalls. Fam Med, 2009; 41(7): 513-515. Heeks, R. Health information systems: Failure, success and improvisation. International journal of medical informatics, 2006; 75(2):125-137.

12. Origins of EMR-driven Quality • Discovery • Validation • Build • Training • Go-Live • Optimization

13. How can AIMS deliver?

14. “Computerized support systems for decision making must present the right information, in the right format, at the right time, and without requiring special effort.” James, B. C. (2001). Making it easy to do it right. The New England Journal of Medicine 2001; 345(13): 991.

15. Structured Data Information Knowledge Decision support Improved quality Balust, J., Macario, A. Can anesthesia information management systems improve quality in the surgical suite?. Current Opinion in Anesthesiology 2009; 22(2): 215-222.

16. Quality?

17. PPO Perspective Organization Provider Patient

18. Patient Guideline-based care • Internal protocols • National measures (PQRS, SCIP) & Error avoidance • Interaction checking • Avoidance of medication errors

19. Point-of-care Decision Support • ACLS algorithms • MH protocol • Transplant protocols • Drug dose calculator

20. Guideline-Based Care • Timely administration of antibiotics • Periop temperature monitoring • Periop Beta-blocker continuation • Periop DVT and embolism prevention • PONV prophylaxis • Medication error prevention

21. Provider Patient & Timely access to patient’s health information • Coordinated communication • Data exchange

22. Organization Provider & Automated screening and aggregation of data • Surveillance and monitoring

23. Anesthesia Clinical Leader • System Administrator • System configuration • Log-in access • Security clearance • Clinician • Clinical Analyst

25. Patient

27. Quality Reports

28. Real-time Patient Experience

29. Patient

30. Operational Reports

31. Patient

32. Organization

33. Organization

36. Organization

38. Organization =IF(AND(OR(Antibiotics<>"vancomycin",Antibiotics<>"clindamycin",Antibiotics<>"levaquin"),(OR(incision_admin<0,incision_admin>60))),"missed","No")

39. Organization =IF(AND(OR(Specialty="URO",Specialty="NEURO"),OR(Antibiotics="cefazolin",Antibiotics="ciprofloxacin",Antibiotics="ceftriaxone",………….”yes",IF(AND(Specialty="ORTHO",OR(Antibiotics= "cefazolin",…………..Antibiotics="ampicillinsulbactam")),"yes","no"))))))

41. Organization

43. Organization

45. Organization

47. Organization

48. Microsoft Excel ® Worksheets

50. Visual Basic for Application Macro