Managing paediatric bleeding disorder patients undergoing surgical procedures: Leveraging the electronic medical record.

Abstract

Individuals with bleeding disorders have a high risk of bleeding complications with surgical procedures. Careful planning and management of peri-operative treatment is vital for their safety. Yet, inter-provider communication and communication between patients/families and providers is not reliable. Our haemophilia treatment centre (HTC) created a care gap report that used the electronic medical record to inform our team when patients with bleeding disorders were scheduled for procedures. An electronic medical record-based patient registry was linked to the hospital's surgical schedule and a report was run daily by HTC staff for the upcoming 14days. We determined the number of surgeries scheduled for patients with a bleeding disorder without the knowledge of the HTC, identified by the care gap report during the 6months prior to and 2years after implementing the report. Had the report been in effect 6months prior, the majority of surgery cases would have been detected and planned for an average of 10days prior to the procedure. Following implementation, the report identified 62 of 225 surgeries on patients with known bleeding disorders where the HTC did not have prior communication from the patient/family or surgical team. This surgery care gap report provides the date and time of procedures on bleeding disorder patients without relying on contact from patients/families or the surgical team. Its use has resulted in an improved peri-operative process for patients with bleeding disorders undergoing surgical procedures and potentially prevented surgery cancellations.