Surgery is always a very sensitive undertaking, often with major risks for the patient’s life. It requires constant monitoring, observations, and adjustments to keep the entire perioperative period as safe and comfortable as possible. Every patient event, clinical action, vital sign, and reaction needs to be tracked and documented throughout, to ensure the best possible continuum of care from the pre-op assessment, through intra-op, to discharge from the PACU, and extending to the ICU and general wards.
Monitoring subtle changes and interpreting them in an instant demands tremendous focus and energy from the surgical team. And having to document everything as they work adds to the challenge. Having devices automatically feed their data into the system helps ensure a high level of accuracy and timely responses. It enables clinicians to focus more on patients and less on the patient file, enhancing overall care quality and significantly improving patient safety, leading to reduced morbidity and mortality.
What You Will Learn
- How anesthesia management systems improve patient safety.
- Ways these systems reduce human error and enhance communication.
- Insights into medication safety and early detection during surgery.
- Benefits of optimized care in the PACU with advanced systems.
What is an Anesthesia Management System?
An Anesthesia Management System, or Anesthesia Information Management System (AIMS), is a digital solution designed to support clinicians throughout the perioperative process. It helps streamline tasks like pre-operative assessments, intraoperative monitoring and documentation, and post-operative documentation, ensuring accurate and efficient workflows. As with any clinical information system, technological integrations with medical devices and hospital systems are key for anesthesia management. By connecting with other hospital systems, an AIMS provides clinicians with timely insights and simplifies data management.
Patient safety is one of the key benefits of a patient management system. Following are the five key ways that such a system helps.
1. How Anesthesia Management Systems Reduce Human Error
Digital documentation is the basis for one of the most significant patient safety benefits of an automated anesthesia information management system – reduced human error. By automatically capturing and recording system and device data, and providing rule-based alerts, the potential for mistakes is reduced.
The following benefits all help to avoid mistakes.
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Track patient events, automatically alerting anesthetists.
With a system to automate anesthesia information, clinicians have a reliable “second pair of eyes”, constantly assessing the patient’s vital signs and stats, even if they are not at the patient’s bedside. This is especially crucial in light of the increasing shortage of anesthesiologists in the US1, Canada2, the UK3, and around the globe. While ideally there should be an anesthesiologist or anesthesia nurse at the patient’s bedside, it has become increasingly complicated to reach that goal. While not recommended, the system can partially compensate if a student is left attending, while the senior doctor is called to an emergency.
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Improve communication among surgical team members.
Clear charts and alerts generated throughout the perioperative period ensure clinicians are on the same page. Intra-op, this ensures all relevant patient data, drug doses, and case narratives are accurately recorded and easily accessible, minimizing the risk of miscommunication due to illegible handwriting or incomplete records. Timely alerts for critical events or deviations from expected parameters enable the full team to coordinate an immediate response. With complete and accurate, electronic anesthesia records – including all the notes, details of medications, and communications in one place – clinicians across units can continue to interact effectively to optimize patient care.
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Reduce bureaucratic demands on clinicians.
Having clear and accessible automatically generated documentation can streamline the workflow, reducing the time spent on clarifying orders or patient status. This can reduce the burden of documentation on clinicians, freeing them to focus on patient care, while ensuring compliance with government, hospital, and payor protocols. Electronic data capture from medical devices and barcode scanning (replacing manual recording) help remove pressure on clinicians, reducing the likelihood of mistakes.
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Reduce cognitive overload.
An anesthesia management system designed with a user-friendly interface and offering customizable workflows for specific types of surgeries helps to reduce cognitive overload for clinicians by reducing the number of clicks needed to complete tasks. Further, guidance throughout the documentation process can help ensure no critical details are overlooked. With the system prompting them to complete necessary steps, clinicians do not have to rely solely on memory for every aspect of patient care documentation, reducing the risk of forgetting important information and minimizing the potential for errors.
2. Improving Medication Safety
Surgery under general anesthesia causes immense stress on a patient’s body, as they are essentially in a medically induced coma. It also introduces numerous risks such as the possibility of hemorrhage, infection, and fluid loss. The coma state and additional risks increase the complexity of medication management while making it even more vital that correct, precise doses of anesthesia are monitored and adjusted throughout.
The sensitive nature of some of the medications that are used in surgery, whose incorrect administration may have critical effects on the patient, makes precise medication management even more crucial. There are also additional pre-surgery medications that need accounting for and may need pre-prescribing post-surgery. The team needs to know what to administer before, during, and after surgery, with special emphasis on allergies.
An advanced, automated anesthesia management system can help improve medication safety on multiple levels. For example, MetaVision Anesthesia’s unique ability to support up to eight TCI (target-controlled infusion) pumps simultaneously, provides an additional layer of functionality that helps ensure the correct and safe level of sedation and IV medications throughout surgery.
An electronic system can ensure that medication prescriptions temporarily halted in the immediate pre- and post-op period are not forgotten, by prompting the clinician to prescribe them again as part of the post-PACU instructions.
Furthermore, such a system can integrate with medication dispensing systems, ensuring the right drugs are available when needed.
At the Hadassah Hebrew University Medical Center, it was found that by employing iMDsoft’s clinical information system MetaVision Anesthesia to improve adherence to postoperative nausea and vomiting (PONV) prevention protocols, the number of patients who got the correct dosage of medication rose from 70.2% to 93.5%. In addition, a 25% decrease in the number of patients who got the PONV drug too early was recorded. Both results demonstrate a significant improvement in patient safety and comfort.
As an advanced, automated anesthesia information management system, MetaVision Anesthesia accommodates protocols like dosing ranges and dosing patterns. This is essential for varied care scenarios, for instance, a patient that needs to be weaned off opioids prescribed for pain management pre- or post-surgery. This facilitates more holistic health. Additionally, MetaVision Anesthesia supports the printing of color-coded dose barcode labels, according to customization, resulting in easier identification of medications, fewer errors, shorter response times and more accurate documentation – all essential steps towards perioperative safety.
3. Early Detection During Surgery with Anesthesia Systems
During surgery, an anesthesia information management system can be configured with clinical decision support parameters for efficient intra-operative workflows that trigger alerts for abnormal vital signs, changes in patient status, or potential adverse drug events, prompting action by the clinician.
For example, if surgery takes longer than anticipated, an alert can automatically notify the clinician that this is the time for a prophylactic dose of antibiotics, per hospital protocol.
Using MetaVision Anesthesia, Lehigh Valley Health Network in the US achieved a 99.6% compliance rate with the antibiotic timing quality measure. A result reflecting both improved protocol compliance and better patient care.
Likewise, with a system such as MetaVision Anesthesia, events that clinicians would like to detect can be configured according to various parameters, and alerts customized accordingly. For example, if the patient’s blood pressure goes above a certain threshold, or their pulse drops below a certain range, the system issues a warning.
4. Enhanced PACU Care with Anesthesiology Management Systems
During surgery, treatment protocols can be registered in the system, for reference in the post-anesthesia care unit (PACU). This ensures that PACU nurses have immediate access to prescriptions, saving time and allowing for immediate intervention in critical situations, such as patients experiencing bleeding, low blood pressure, or significant pain.
The patient record is automatically populated with information, including clinical scores, which continues to be updated throughout the patient’s admission. This helps improve overall care, as well as prioritization. With accurate clinical data and always up-to-date status reports, clinicians can identify the most critical and time-sensitive cases at a glance. They can objectively determine which patients to visit first during rounds, and when to facilitate rapid intervention.
An electronic system can also assist with effective post-operative pain management, a crucial aspect of PACU care. In the case of MetaVision Anesthesia, the system clearly displays variations in pain scores in relation to administered medications and vital signs, helping clinicians determine the most relevant medication and dosage for each patient. And the ability to configure alerts for extubation criteria and patient release readiness ensures timely and efficient patient transitions, minimizing the risk of oversight and enhancing overall patient care and safety.
5. Supporting More Informed Decision-making and Follow-up
Electronic data capture from medical devices and the standardized documentation supported by anesthesia management systems are also critical for informed clinical decision making.
Utilizing a combination of historical and granular patient data, the anesthesia information management system can track multiple parameters and provide protocols, templates and information at the point of care, offering timely guidance based on best practice guidelines.
For example, MetaVision Anesthesia tracks vital signs, medications, and fluids and it provides scores and multi-parametric smart alerts that help clinicians recognize adverse events, and deterioration. This can be particularly helpful for less experienced anesthesiologists, or in complex cases.
When the system accommodates drug titration, as MetaVision Anesthesia does, it further simplifies the ability to adjust drug dosage for maximum benefit, while minimizing adverse effects.
With accurate records automatically available in the PACU, follow-up care is more streamlined. This ensures that essential medications are administered and monitoring protocols are followed consistently reducing the risk of missed steps, and avoiding the introduction of variations in care.
Key takeaways
- An anesthesia information management system is a valuable tool for improving patient safety and care throughout surgery.
- Anesthesia management systems automate data capture and alerts and help anesthesiologists with tasks like monitoring vitals and medication, reducing the potential for human error during surgery.
- These systems can also help improve communication among surgical teams by automatically creating clear records and prompting clinicians throughout the perioperative process.
- They can further enhance patient safety by enabling early detection of issues during surgery and optimizing care in the recovery unit.
- These systems streamline documentation, reducing bureaucratic demands and cognitive overload on clinicians.
- Post-anesthesia care is optimized by providing immediate access to treatment protocols and real-time patient data, ensuring prioritized and effective patient management.
- Standardized documentation supports informed clinical decision-making and follow-up care, enhancing overall patient safety and outcomes.
MetaVision Anesthesia helps improve patient safety
In a discipline rife with risks and exacting details, an automated clinical information management system offers benefits towards patients’ safety and care. By reducing human error, improving drug safety, enabling early detection, and supporting better decision-making, MetaVision Anesthesia helps clinicians provide the most precise treatment possible throughout the perioperative period, from pre-op management to the PACU. In addition to freeing them up to deliver the best possible care in the most challenging circumstances, the support provided by timely data and alerts increases clinicians’ confidence and performance, enhancing patient safety, comfort, and outcomes.
FAQs
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What is an automated anesthesia management system?
An automated anesthesia management system (AIMS) streamlines and enhances the documentation and monitoring of anesthesia care before, during and after surgery. It automates data capture from patient monitors, integrates with medication management systems, and provides timely notifications to clinicians.
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What are the primary benefits of an automated anesthesiology management system?
Anesthesia management systems enhance patient safety and clinical outcomes by offering a comprehensive and standardized approach to anesthesia documentation. They help anesthesiologists and anesthesia nurses manage patient care more effectively, by reducing human error, enabling early detection of issues, improving communication, and ensuring precise medication administration.
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How does an anesthesiology management system reduce human error?
By automatically capturing and recording data from devices and providing rule-based alerts, the system minimizes the potential for mistakes, allowing clinicians to focus more on patient care.
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How does an automated anesthesia management system improve medication safety during surgery?
The system ensures precise monitoring and management of anesthesia and other medications and supports adherence to protocols.
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How does an anesthesia management system aid in early detection of intra-operative issues?
The system can be configured with clinical decision support parameters that trigger alerts for abnormal vital signs or potential adverse drug events, prompting timely action by the clinician to address issues as they arise.
REFERENCES
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Menezes, J., & Zahalka, C. (2024). Anesthesiologist shortage in the United States: A call for action. Journal of Medicine, Surgery, and Public Health, April 2, 2024, 100048, ISSN 2949-916X.
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Toronto Star. A shortage of these experts in Ontario is resulting in cancelled surgeries, doctors say, August 4, 2023
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Association of Anaesthetists. Action must be taken to help retain older anaesthetists to prevent staff shortage of 11,000 by 2040, preventing more than 8 million operations, September 29, 2024.