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Creating Quality-Driven Operational Reports . David Sinclair MD Associate Professor of Clinical Anesthesiology Associate Chief of Anesthesiology Co -Director of Informatics Epic UChart Physician Champion. Toyota Advanced Quality Information Center.

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Creating Quality-Driven Operational Reports


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    Presentation Transcript
    1. Creating Quality-DrivenOperational Reports David Sinclair MD Associate Professor of Clinical Anesthesiology Associate Chief of Anesthesiology Co-Director of Informatics Epic UChart Physician Champion

    2. Toyota Advanced Quality Information Center “…a multimillion dollarcomputer system manned by 20 employees who compile repair reports from Toyota dealerships world-wide…and will be accessible on an as-needed basis.” Chester Dawson and Yoshio Takahashi, “Toyota Makes New Push to Avoid Recalls,” The Wall Street Journal, February 24, 2011

    3. Improving Quality Through Meaningful Use

    4. Can AIMS Deliver?

    5. Quality of Care EMR

    6. Electronic Medical Record Pitfalls Gill, J. M. EMRs for improving quality of care: promise and pitfalls. Fam Med, 2009; 41(7): 513-515. Heeks, R. Health information systems: Failure, success and improvisation. International journal of medical informatics, 2006; 75(2):125-137.

    7. Origins of EMR-driven Quality • Discovery • Validation • Build • Training • Go-Live • Optimization

    8. How can AIMS deliver?

    9. “Computerized support systems for decision making must present the right information, in the right format, at the right time, and without requiring special effort.” James, B. C. (2001). Making it easy to do it right. The New England Journal of Medicine 2001; 345(13): 991.

    10. Structured Data Information Knowledge Decision support Improved quality Balust, J., Macario, A. Can anesthesia information management systems improve quality in the surgical suite?. Current Opinion in Anesthesiology 2009; 22(2): 215-222.

    11. Quality?

    12. PPO Perspective Organization Provider Patient

    13. Patient Guideline-based care • Internal protocols • National measures (PQRS, SCIP) & Error avoidance • Interaction checking • Avoidance of medication errors

    14. Point-of-care Decision Support • ACLS algorithms • MH protocol • Transplant protocols • Drug dose calculator

    15. Guideline-Based Care • Timely administration of antibiotics • Periop temperature monitoring • Periop Beta-blocker continuation • Periop DVT and embolism prevention • PONV prophylaxis • Medication error prevention

    16. Provider Patient & Timely access to patient’s health information • Coordinated communication • Data exchange

    17. Organization Provider & Automated screening and aggregation of data • Surveillance and monitoring

    18. Anesthesia Clinical Leader • System Administrator • System configuration • Log-in access • Security clearance • Clinician • Clinical Analyst

    19. Patient

    20. Quality Reports

    21. Real-time Patient Experience

    22. Patient

    23. Operational Reports

    24. Patient

    25. Organization

    26. Organization

    27. Organization

    28. Organization =IF(AND(OR(Antibiotics<>"vancomycin",Antibiotics<>"clindamycin",Antibiotics<>"levaquin"),(OR(incision_admin<0,incision_admin>60))),"missed","No")

    29. Organization =IF(AND(OR(Specialty="URO",Specialty="NEURO"),OR(Antibiotics="cefazolin",Antibiotics="ciprofloxacin",Antibiotics="ceftriaxone",………….”yes",IF(AND(Specialty="ORTHO",OR(Antibiotics= "cefazolin",…………..Antibiotics="ampicillinsulbactam")),"yes","no"))))))

    30. Organization

    31. Organization

    32. Organization

    33. Organization

    34. Microsoft Excel ® Worksheets

    35. Visual Basic for Application Macro