Technology used to enhance medication awareness/visibility in electronic health record: Multi-disciplinary collaboration and impact on perioperative procedural patient safety.

Abstract

470 Background: Many patients undergoing procedures at MD Anderson are diagnosed with conditions necessitating anti-coagulant medications taken in the perioperative timeframe. Holding these medications prior to surgery is essential to avoid perioperative complications and procedural delays/cancellations. Failure to hold anti-coagulants could delay necessary cancer treatment. Hypothesis presented: implement a technology solution to enhance the awareness and visibility of these medications within the electronic health record (EHR) to assist in alerting multi-disciplinary care team members. With increased awareness across the perioperative clinical care team, cancellations/delays are expected to improve. Methods: In the fourth quarter of 2020 (* mark in data below), perioperative anesthesia and information technology (IT) teams collaborated to create a visual banner “watch meds” in the EHR. Banner is easily visible above the summary of each patient’s medication list. An institution wide education and awareness campaign highlighting “watch-meds” banner was done by anesthesia/surgical/perioperative teams. Patients meeting the following criteria were identified in the EHR: diagnosis necessitating anticoagulation, anticoagulant use, and scheduled OR procedure. Delays and cancellations on the procedure day for patients meeting criteria from 1/1/2020-12/31/2022 were analyzed, comparing pre and post implementation effects. Results: Case delays and cancellations impact time and labor resources, lead to equipment and material waste, and delay cancer care. Timely surgical completion carries tremendous impact on patient safety, satisfaction, and resource preservation. The number of patients who met criteria for the banner warning was 8% of the total number of cases throughout the three-years recorded. Of those who met criteria, 62% resulted in case delays. Implementation of the banner warning resulted in an immediate 2-fold improvement in cancellations, and ultimately demonstrated a 3-fold stable improvement. Conclusions: Leveraging technology to enhance visual cues in the EHR can be a powerful tool to relay important patient information including medications affecting perioperative care to all care team members, thus enhancing patient safety.[Table: see text]