Anesthesia Information Management System-Based Near Real-Time Decision Support to Manage Intraoperative Hypotension and Hypertension

2014 ◽  
Vol 118 (1) ◽  
pp. 206-214 ◽  
Author(s):  
Bala G. Nair ◽  
Mayumi Horibe ◽  
Shu-Fang Newman ◽  
Wei-Ying Wu ◽  
Gene N. Peterson ◽  
...  
Keyword(s):  
Decision Support ◽  
Real Time ◽  
Information Management ◽  
Management System ◽  
Information Management System ◽  
Anesthesia Information Management System ◽  
Intraoperative Hypotension

Detection of Intraoperative Incidents by Electronic Scanning of Computerized Anesthesia Records

1996 ◽  
Vol 85 (5) ◽  
pp. 977-987 ◽  
Author(s):  
Kevin V. Sanborn ◽  
Jose Castro ◽  
Max Kuroda ◽  
Daniel M. Thys
Keyword(s):  
Information Management ◽  
Management System ◽  
Arterial Oxygen Saturation ◽  
Strong Association ◽  
Information Management System ◽  
Anesthesia Information Management System ◽  
Arterial Oxygen ◽  
Anesthesia Record ◽  
Voluntary Reporting ◽  
Physiologic Data

Background The use of a computerized anesthesia information management system provides an opportunity to scan case records electronically for deviations from specific limits for physiologic variables. Anesthesia department policy may define such deviations as intraoperative incidents and may require anesthesiologists to report their occurrence. The actual incidence of such events is not known. Neither is the level of compliance with voluntary reporting. Methods Using automated anesthesia record-keeping with long-term storage, physiologic data were recorded every 15 s from 5,454 patients undergoing noncardiothoracic surgery. Recorded measurements of blood pressure, heart rate, arterial oxygen saturation, and temperature were electronically analyzed for deviations from defined limits. The computer system also was used by anesthesiologists to report voluntarily those deviations as intraoperative incidents. For each electronically detected incident: 1) the complete automated anesthesia record was examined by two senior anesthesiologists who, by consensus, eliminated case records with artifact or in which context suggested that the incident was not clinically relevant, and 2) the anesthesia information management system database was checked for voluntary reporting. Results In 473 automated anesthesia records, 494 incidents were found by electronic scanning of 5,454 automated anesthesia records. Sixty intraoperative incidents were eliminated, 25 due to artifact and 35 due to context. When the remaining 434 intraoperative incidents were checked for voluntary reporting, 18 (4.1%) matching voluntary reports were found. All intraoperative incidents that were reported voluntarily also were detected by electronic scanning. Based on a 10% sample, the sensitivity rate of electronic scanning was 97.2% (35/36), and the specificity rate was 98.4% (427/434). Among 413 cases with electronically detected intraoperative incidents, there were 29 deaths (7.0%), whereas there were only 79 deaths (1.6%) among 5,041 cases without incidents (chi 2 = 58.5, P < 0.001). Conclusions The use of an anesthesia information management system facilitated analysis of intraoperative physiologic data and identified certain intraoperative incidents with high sensitivity and specificity. A low level of compliance with voluntary reporting of defined intraoperative incidents was found for all anesthesiologists studied. Finally, there was a strong association between intraoperative incidents and in-hospital mortality.

An Anesthesia Information Management System (AIMS) as a Tool for Controlling Resource Management of Operating Rooms

2002 ◽  
Vol 41 (01) ◽  
pp. 81-85 ◽  
Author(s):  
A. Junger ◽  
L. Quinzio ◽  
A. Michel ◽  
G. Sciuk ◽  
D. Brammen ◽  
...  
Keyword(s):  
Information Management ◽  
Management System ◽  
Information Management System ◽  
Operating Rooms ◽  
Anesthesia Information Management System ◽  
Management Tool ◽  
Anesthesia Record ◽  
Time Data ◽  
Or Management ◽  
Surgical Subspecialty

Summary Objectives: In our department, we have been using an Anesthesia Information Management System (AIMS) for five years. In this study, we tested to what extent data extracted from the AIMS could be suitable for the supervision and time-management of operating rooms. Methods: From 1995 to 1999, all relevant data from 103,264 anesthetic procedures were routinely recorded online with the automatic anesthesia record keeping system NarkoData. The program is designed to record patient related time data, such as the beginning of anesthesia or surgical procedure, on a graphical anesthesia record sheet. The total number of minutes of surgery and anesthesia for each surgical subspecialty per hour/day and day of the year was calculated for each of the more than 40 ORs, amounting to a total of 112 workstations. Results: It was possible to analyze the usage and the utilization of ORs at the hospital for each day of the year since 1997. In addition, annual and monthly evaluations are made available. It is possible to scrutinize data of OR usage from different points of view: queries on the usage of an individual OR, the usage of ORs on certain days or the usage of ORs by a certain surgical subspecialty may be formulated. These data has been used repeatedly in our hospital for decision making in OR management and planning. Conclusions: In assessing the results of our study, it should be considered that the system used is not a specialized OR management tool. Despite these restrictions, the system contains data which can be used for an exact and relevant presentation of OR utilization

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