Reducing Delays in Postoperative Gynecologic Evaluations Through Automated Electronic Alerts

Area of Science:

• Healthcare Quality Improvement
• Emergency Medicine
• Gynecologic Surgery

Background:

• Timely gynecologic evaluation is crucial for patients presenting to the emergency department (ED) within 30 days of surgery.
• Delays in recognition of postoperative complications can negatively impact patient outcomes.

Purpose of the Study:

• To assess the effectiveness of an electronic health record (EHR)-based quality improvement intervention.
• To determine if the intervention can decrease the time to gynecologic evaluation for postoperative patients in the ED.

Main Methods:

• A multidisciplinary approach identified key drivers of delay.
• An EHR notification system alerted providers to postoperative patients in the ED.
• Primary analysis compared preintervention (Oct 2021-Apr 2022) and postintervention (Apr 2022-May 2023) periods.

Main Results:

• The postintervention period showed a significant reduction in the average time from ED arrival to gynecologic evaluation (4.25 ± 2.36 hours vs. 6.08 ± 4.83 hours).
• The intervention was associated with a 2.26-hour reduction in evaluation time, adjusted for age (p < 0.01).
• Median time from rooming to first chart opening decreased from 57.1 to 11.9 minutes (p = 0.001).

Conclusions:

• The EHR-based quality improvement intervention successfully reduced the latency from ED arrival to gynecologic evaluation.
• This project demonstrates the efficacy of EHR notifications in streamlining postoperative patient care in the ED.