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D W Edsall

Publications and source records attributed to D W Edsall.

8 recordsLinked to original sources
PubMed1991

Quality assessment with a computerized anesthesia information management system (AIMS).

Private practice anesthetists are skeptical about the worth of quality assessment programs because of the difficulty of creating and maintaining an accurate and efficient medical record, the paucity of data caused by the recent shift in emphasis from process to outcome data, the tendency of adverse outcomes to be presented with no denominators, the lack of integration between process and outcome data, and the tendency for quality assessment programs to require duplicate documentation. An efficient anesthesia information management system (AIMS) gathers accurate, complete, and legible information before, during, and after each anesthetic procedure. One such system used in a private practice setting at Burbank Hospital, Fitchburg, Massachusetts, has a computerized data base to draw from preoperative, intraoperative, and postoperative events, with a judicious selection of both process and outcome indicators. The clinical anesthesia data base can be an effective tool for practical and efficient clinical competency evaluations and can lead to many improvements in the quality of anesthesia care delivery.

Anesthesia Department, Hospital↗
PubMedDate not supplied

Computerized patient anesthesia records: less time and better quality than manually produced anesthesia records.

STUDY OBJECTIVE: To compare manual and computerized anesthesia information management systems (AIMS's) with respect to time demands on the anesthetist and record quality. DESIGN: Videotaped clinical anesthesia cases were independently reviewed along with the records produced. SETTING: Private practice anesthesia at a 150-bed community hospital. PATIENTS: Ten consecutive ASA physical status I patients having video arthroscopy of the knee by the same surgeon and having general anesthesia. INTERVENTIONS: One anesthetist recorded six cases: three with the computer and three manually. Two more anesthetists each recorded two cases: one with the computer and one manually. MEASUREMENTS AND MAIN RESULTS: The proportion of the anesthetist's time spent on the documentation for the computer records was significantly less than that spent on manual records (14.9% vs. 36.6%; p < 0.001). Nevertheless, significantly more vital sign data points were recorded on the computer than on the manual records (245.2 vs. 45.0 vital sign points per case; p < 0.001), as well as significantly more notes and drug information (61.0 vs. 40.0 notes per case; p < 0.02). The computer record was always legible, but this was not the case with the manual records. There was no significant difference in the number of artifacts detected on the records. CONCLUSION: The concern that the introduction of computerized AIMS's may complicate the anesthesia working environment by requiring more time than manual AIMS's and thus detracting from direct patient care is not supported by this study. In fact, this computer approach not only required less time but also produced a more complete and higher-quality record than did the manual AIMS.

Anesthesiology↗