Behavioral Economic Strategies Increase Adverse Event Reporting in Pediatric Anesthesia

Area of Science:

• Anesthesiology
• Patient Safety
• Health Informatics

Background:

• Accurate identification and reporting of severe adverse events (SAEs) are crucial for enhancing perioperative patient care.
• Under-reporting of SAEs, often due to reliance on self-reporting, hinders the accurate assessment of event incidence.
• Electronic Medical Records (EMRs), particularly Anesthesia Information Management Systems (AIMS), offer a potential solution to improve reporting.

Purpose of the Study:

• To assess the impact of behavioral economic-based interventions on the reporting rates of SAEs in anesthesia care.
• To evaluate the effectiveness of modifying EMR systems to increase SAE reporting.
• To determine if simple, low-impact interventions can improve the identification of notable events in perioperative settings.

Main Methods:

• The study followed the Institute for Healthcare Improvement's Model of Improvement.
• Behavioral economic-based interventions were implemented, including a mandatory "hard stop" in the EMR system.
• Anesthesiologists were required to report the occurrence or absence of a "notable event" before closing a patient encounter.

Main Results:

• At baseline, only 53% of SAEs were self-reported.
• Following the interventions, the self-reporting rate of SAEs increased to over 75%.
• This represents a relative increase of 42% in the reporting of SAEs.

Conclusions:

• Simple modifications to the EMR system can significantly increase the reporting of SAEs.
• These interventions were implemented with limited financial impact and minimal workflow interruption.
• Improved reporting facilitates better identification of areas for improvement in perioperative patient care.