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Development and implementation of local pediatric anesthesia performance metrics at a Canadian children's hospital: a
Conor Mc Donnell1,2, Casey Li3, Clyde Matava4,5
1Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), 555 University Avenue, Toronto, ON, M5G 1X8, Canada. conor.mcdonnell@sickkids.ca.
Insights
Pediatric anesthesia metrics were developed and integrated into electronic health records (EHR) to enhance patient care quality and safety. This system provides real-time insights, promoting continuous learning in hospitals.
Area of Science:
- Anesthesiology
- Health Informatics
- Quality Improvement
Background:
- Electronic Health Records (EHR) are widely adopted, yet specific metrics for pediatric anesthesia quality and safety are lacking.
- Metric-driven healthcare is increasing, highlighting the need for tailored pediatric anesthesia performance indicators.
- EHR implementation offers opportunities to develop and deploy customized metrics for improved patient care and transparent reporting.
Purpose of the Study:
- To develop and implement pediatric anesthesia metrics within an EHR system.
- To enhance the quality and safety of pediatric anesthesia care.
- To provide transparency in reporting through data-driven insights.
Main Methods:
- A quasi-nominal consensus group design was used to gather requirements from anesthesiologists.
- Agile methodology guided the development of 45 quality of care and provider performance metrics.
- Metrics were integrated into the EHR, transitioning feedback from PDF reports to interactive Power BI dashboards.
Main Results:
- Customized pediatric anesthesia metrics were successfully developed and implemented in an academic pediatric hospital.
- The developed metrics address key aspects of care, including induction, anesthesia delivery, and postanesthetic care.
- Interactive dashboards replaced static PDF reports, enabling more dynamic data visualization and feedback.
Conclusions:
- The implemented pediatric anesthesia metrics framework is adaptable to other clinical specialties and institutions.
- Leveraging EHR capabilities, these metrics facilitate real-time monitoring and a culture of continuous learning.
- The project aligns with the strategic goals of high-reliability organizations by enhancing patient safety and care quality.
Purpose:
In this project, we sought to develop and implement pediatric anesthesia metrics into electronic health records (EHR) in a hospital setting to improve quality and safety of patient care. While there has been an upsurge in metric-driven health care, specific metrics catering to pediatric anesthesia remain lacking despite widespread use of EHR. The rapid proliferation and implementation of EHR presents opportunities to develop and implement metrics appropriate to local patient care, in this case pediatric anesthesia, with the strategic goal of enhancing quality and safety of patient care, while also delivering transparency in reporting of such metrics.
Clinical Features:
Using a quasi-nominal consensus group design, we collected requirements from attending anesthesiologists using Agile methodology. Forty-five metrics addressing quality of care (e.g., induction experience, anesthesia delivery, unanticipated events, and postanesthetic care unit stay) and provider performance (e.g., bundle-compliance, collaboration, skills assurance) were developed. Implementation involved integration into the EHR followed by transition from PDF-based feedback to interactive Power BI (Microsoft Corporation, Redmond, WA, USA) dashboards.
Conclusion:
We introduced and implemented customized pediatric anesthesia metrics within an academic pediatric hospital; however, this framework is easily adaptable across multiple clinical specialties and institutions. In harnessing data-collecting and reporting properties of EHR, the metrics we describe provide insights that facilitate real-time monitoring and foster a culture of continuous learning in line with strategic goals of high-reliability organizations.
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