Using physiological monitoring data for performance feedback: an initiative using thermoregulation metrics

Abstract

Feedback of intraoperative thermoregulation management improved both group and individual performances as measured by significant, sustained reductions in temperature-monitoring delays. Thus, intraoperative vital signs data may improve the quality of, and reduce the variability in, anesthetic practice.

Closing the gap: applying the Theoretical Domains Framework to improve knowledge translation

“…Based on this, the authors recommend the development of a comprehensive formal audit and feedback process to improve practices. Interestingly, their finding is in keeping with a recent study by Görges et al 7 in which pediatric spine anesthesiologists were provided with both individual and team feedback regarding the time delay from the start of the case to the first temperature monitoring. The provision of intraoperative thermoregulation data resulted in a significant and sustained reduction in the time delays for temperature monitoring at the individual and team levels, which underlines the importance of providing feedback for consistency of practice.…”

Real-time physiologic monitoring and physician feedback: Are we ready?

“…1 Spine anesthesiologists at their centre were provided with individual and group feedback on two variables for patients undergoing scoliosis surgery, namely, the percentage of time that their patients were hypothermic and the time delay from the start of the case to the first temperature monitoring (i.e., the primary outcome). While the authors did not find a difference in clinical outcomes, the delay to temperature monitoring in the operating room was reduced when anesthesiologists were given individual and group data on intraoperative temperature.…”

“…Furthermore, the authors reasoned that the reduction in time to monitor intraoperative temperature offers some evidence that providing feedback data on intraoperative vital signs may reduce physician variability and could eventually contribute to improved perioperative outcomes. 1 The concept of physician feedback as a QI tool is becoming increasingly popular. Some have argued that physician feedback should play an integral role in clinical practice for anesthesiologists, as it not only provides QI opportunities but also offers an opportunity for reflective and self-directed learning.…”

“…3 Moreover, Görges et al speculated that clinicians' intrinsic competitiveness through group feedback drove at least some of the improvements observed. 1 It is possible that the provision of feedback results in a Hawthorne effect -i.e., that the knowledge of being measured actually changes behaviour. While this may affect the external validity, QI studies are largely observational in design with the goal to modify current practice at a single organization.…”

“…In the study by Görges et al, each anesthesiologist was given a unique identifier for QI purposes known only to them. 1 The authors used this approach to maintain anonymity and perhaps cultivate a safe learning environment.…”