Anesthesiology: From Patient Safety to Population Outcomes

Tremper, Kevin K.

doi:10.1097/aln.0b013e31820fc9d3

Cited by 13 publications

(4 citation statements)

References 40 publications

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“…AlertWatch® OR is a multifunction display, driven by live data extracted from physiologic monitors and the EMR, displayed in a readily identifiable icon view of organ systems, Fig. 2 [ 14 , 15 ]. This display extracts, analyzes and presents over 250 pieces of information, providing a “live” organ system view with a beating heart, expanding/contracting aortic arch and ventilating lungs.…”

Section: Introductionmentioning

confidence: 99%

Design of a Novel Multifunction Decision Support Display for Anesthesia Care: AlertWatch® OR

et al. 2018

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BackgroundThis paper describes the design of a multifunction alerting display for intraoperative anesthetic care. The design was inspired by the multifunction primary flight display used in modern aviation.ResultsThe display retrieves live data from multiple sources; the physiologic monitors, the anesthesia information management system, the laboratory values and comorbidities from patient’s problem summary list, medical history or history & physical. This information is integrated into a display composed of readily identifiable icons of organ systems, which are color coded to signify normal range, marginal range, abnormal range (by green, yellow, red respectively) and orange outlines for comorbidities/risk factors. There are dozens of text alerts, which can be presented as black text (informational), red text (important information) and red scrolling text (highest importance information). The alerts are derived from current standards in the literature and some involve complex calculations being conducted in the background.ConclusionsThe goal of such a system is to improve the quality and safety of anesthetic care by providing enhanced situational awareness in a fashion analogous to the “glass cockpit” and its primary flight display which has improved aviation safety.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0478-8) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Design of a Novel Multifunction Decision Support Display for Anesthesia Care: AlertWatch® OR

et al. 2018

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“…As we transition in the field of anesthesiology, we must recollect the words of Dr Ellison Pierce during the Emery Rovenstine 34 th lecture: “Patient safety is not a fashion nor a preoccupation of the past. It is not a problem that has been solved, but rather an ongoing requirement.”[30]…”

Section: Resultsmentioning

confidence: 99%

Beyond the borders: Lessons from various industries adopted in anesthesiology

Mahankali

Nair

2019

J Anaesthesiol Clin Pharmacol

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Since the first public demonstration of anaesthesia in Boston, USA which happened around 172 years back, the field of anesthesiology has rapidly progressed, with many developments that have improved the quality and safety of anesthesia care. This has enabled tremendous advances in the surgical disciplines and increasing the life expectancy and quality of life of humans. This is a result of learning and constantly evolving. There are several similarities between healthcare and other industries, though there are several distinguishing characteristics that set it apart from other industries. There are a number of safety and quality improvement measures in healthcare which have been influenced by safety practices in other industries. Anaesthesia has been the leader among the medical specialities in adoption of innovative practices from various industries in an effort to advance patient safety, enhance quality of care, reduce waste & inefficiency, and improve customer service and satisfaction. This article emphasises on learnings from other industries in the recent decades, focusing on aviation, high-reliability organizations, car manufacturing, telecommunication, car racing, entertainment, and retail. Learning and implanting the best practices from these industries can bring about a paradigm shift in health care industry. It has a potential to improve efficiency and make anaesthesia safer than ever before in the history of human kind.

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“…It has long been determined that even highly trained and motivated personnel’s ability to detect adverse events deteriorates over a matter of hours. This phenomenon was originally demonstrated in the context of assessment of the vigilance of sonar operators to detect enemy submarines [ 26 ]. The aviation industry has addressed this issue as the complexity of the aircraft’s monitoring systems increased.…”

Section: Discussionmentioning

confidence: 99%

Design of a novel multifunction decision support/alerting system for in-patient acute care, ICU and floor (AlertWatch AC)

et al. 2021

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Background Multifunction surveillance alerting systems have been found to be beneficial for the operating room and labor and delivery. This paper describes a similar system developed for in-hospital acute care environments, AlertWatch Acute Care (AWAC). Results A decision support surveillance system has been developed which extracts comprehensive electronic health record (EHR) data including live data from physiologic monitors and ventilators and incorporates them into an integrated organ icon-based patient display. Live data retrieved from the hospitals network are processed by presenting scrolling median values to reduce artifacts. A total of 48 possible alerts are generated covering a broad range of critical patient care concerns. Notification is achieved by paging or texting the appropriated member of the critical care team. Alerts range from simple out of range values to more complex programing of impending Ventilator Associated Events, SOFA, qSOFA, SIRS scores and process of care reminders for the management of glucose and sepsis. As with similar systems developed for the operating room and labor and delivery, there are green, yellow, and red configurable ranges for all parameters. A census view allows surveillance of an entire unit with flashing or text to voice alerting and enables detailed information by windowing into an individual patient view including live physiologic waveforms. The system runs via web interface on desktop as well as mobile devices, with iOS native app available, for ease of communication from any location. The goal is to improve safety and adherence to standard management protocols. Conclusions AWAC is designed to provide a high level surveillance view for multi-bed hospital units with varying acuity from standard floor patients to complex ICU care. Alerts are generated by algorithms running in the background and automatically notify the selected member of the patients care team. Its value has been demonstrated for low acuity patients, further study is required to determine its effectiveness in high acuity patients.

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Anesthesiology: From Patient Safety to Population Outcomes

Cited by 13 publications

References 40 publications

Design of a Novel Multifunction Decision Support Display for Anesthesia Care: AlertWatch® OR

Design of a Novel Multifunction Decision Support Display for Anesthesia Care: AlertWatch® OR

Beyond the borders: Lessons from various industries adopted in anesthesiology

Design of a novel multifunction decision support/alerting system for in-patient acute care, ICU and floor (AlertWatch AC)

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