Accepted for/Published in: JMIR Perioperative Medicine
Date Submitted: Mar 18, 2023
Date Accepted: Aug 16, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A dashboard of short-term postoperative patient outcomes for anesthesiologists: development and preliminary evaluation
ABSTRACT
Background:
Anesthesiologists require an understanding of their patients’ outcomes to evaluate their performance and improve their practice. Traditionally, anesthesiologists had limited information about their surgical outpatients’ outcomes due to minimal contact post-discharge. Leveraging digital health innovations for analyzing personal and population outcomes may improve perioperative care. BC Children’s Hospital’s postoperative follow-up registry for outpatient surgeries collects short-term outcomes such as pain, nausea, and vomiting. Yet, these data were previously not available to anesthesiologists.
Objective:
This quality improvement study aimed to visualize postoperative outcome data to allow anesthesiologists to reflect on their care and compare their performance with their peers.
Methods:
The postoperative follow-up registry contains nurse-reported postoperative outcomes, including opioid and antiemetic administration in the post-anesthetic care unit (PACU), and family-reported outcomes, including pain, nausea, and vomiting, within 24 hours post-discharge. Dashboards were iteratively co-designed with five anesthesiologists, and a department-wide usability survey gathered anesthesiologists’ feedback on the dashboards, allowing further design improvements. A final dashboard version has been deployed, with data updated weekly.
Results:
The dashboard contains three sections: a) 24-hour outcomes; b) PACU outcomes; c) a practice profile containing individual anesthesiologist’s case mix, grouped by age groups, sex, and surgical service. At the time of evaluation, the dashboard included 24-hour data from 7,800 cases collected September/2020-Feb/2023 and PACU data from 8,715 cases collected April/2021-Feb/2023. The co-design process and usability evaluation indicated that anesthesiologists preferred simpler designs for data summaries but also required the ability to explore details of specific outcomes and cases if needed. Anesthesiologists considered security and confidentiality to be key features of the design and most deemed the dashboard information useful and potentially beneficial for their practice.
Conclusions:
We designed and deployed an interactive, personalized dashboard for anesthesiologists to review their outpatients’ short-term postoperative outcomes. This dashboard facilitates personal reflection on individual practice in the context of peer and departmental performance and, hence, the opportunity to evaluate iterative practice changes. Further work is required to establish their effect on improving individual and department performance and patient outcomes.
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