Automated feedback modestly improves perioperative treatment adherence of postoperative nausea and vomiting

Extensive evidence demonstrates that medical record modernization and a vast amount of available data have not overcome the gap between recommended and delivered care. This study aimed to evaluate the use of clinical decision support (CDS) in conjunction with feedback (post-hoc reporting) to improve...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2023-06, Vol.86, p.111081-111081, Article 111081
Main Authors: Gruss, Calvin L., Kappen, Teus H., Fowler, Leslie C., Li, Gen, Freundlich, Robert E., McEvoy, Matthew D., Rothman, Brian S., Sandberg, Warren S., Wanderer, Jonathan P.
Format: Article
Language:English
Subjects:
Adult
Anesthesia
Anesthesia, General
Antiemetics
Antiemetics - therapeutic use
Automation
Clinical outcomes
Data warehouses
Decision making
Disease prevention
Documentation
Drug administration
Electronic health records
Electronic mail systems
Feedback
Humans
Informatics
Intervention
Medical personnel
Narcotics
Nausea
Patient compliance
Patients
Postoperative Nausea and Vomiting - drug therapy
Postoperative Nausea and Vomiting - epidemiology
Postoperative Nausea and Vomiting - prevention & control
Postoperative period
Regression analysis
Risk assessment
Risk Factors
Variables
Vomiting
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Summary:Extensive evidence demonstrates that medical record modernization and a vast amount of available data have not overcome the gap between recommended and delivered care. This study aimed to evaluate the use of clinical decision support (CDS) in conjunction with feedback (post-hoc reporting) to improve PONV medication administration compliance and postoperative nausea and vomiting (PONV) outcomes. Single center, prospective observational study between January 1, 2015, and June 30, 2017. Perioperative care at a university-affiliated tertiary care center. 57,401 adult patients who received general anesthesia in a non-emergency setting. A multi-phased intervention that consisted of post-hoc reporting for individual providers by email about PONV occurrences in their patients, followed by directive CDS through preoperative daily case emails that provided therapeutic PONV prophylaxis recommendations based on patients' PONV risk scores. Compliance with PONV medication recommendations, as well as hospital rates of PONV were measured. Over the study period, there was a 5.5% (95% CI, 4.2% to 6.4%; p 
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2023.111081