The Use of Patient Digital Facial Images to Confirm Patient Identity in a Children's Hospital's Anesthesia Information Management System

Abstract

Patient identification errors, albeit rare, continue to occur despite the implementation of the Universal Protocol. Researchers at a tertiary care children's hospital hypothesized that introduction of a digital photograph to the preanesthesia checklist would reduce wrong-patient charting and near-miss events around the induction of anesthesia. In late 2014 a digital facial image obtained either on arrival to the preoperative preparation area or for inpatients, on admission to the hospital, was added to the initial verification screen (anesthesia sign-in) of the anesthesia information management system (AIMS). This verification process includes visual inspection of the patient's facial image and checking the patient's hospital ID bracelet for the patient's name, birthdate, and hospital number against the AIMS verification page. Wrong-patient charting and near-miss events were reviewed weekly by the electronic health record (EHR) perioperative team through analysis of AIMS records and through provider self-report to the institution's Anesthesia Incident Reporting System. Between January 1, 2015, and July 1, 2018, 95,146 patients (42,255 females; 52,891 males) were anesthetized in the hospital with only one instance of charting on the wrong patient in the AIMS. A Wilson score interval would give a percentage of 0.001% (95% confidence interval: 0.0002%-0.006%). Therefore, we are 95% certain that the true rate of charting on the wrong patient is below 1 in 16,794 patients. At the induction of anesthesia, the addition of a current digital facial image to the Universal Protocol may be useful in preventing misidentification and mischarting on the anesthetic record.