Perioperative evaluation is an important interaction between a patient and a physician where the physician carefully and accurately where the physician accesses the overall health status and determines the risk against the procedure. In Cleveland clinic the process is complicated and time consuming and in emergency settings, it becomes extremely difficult and often assessments are made last minute. Lack of informatics in this clinic preoperative evaluation endangers patients and creates large inefficiencies. For these reasons, the need for enhanced informatics is needed in order to create and enhance best practices throughout the perioperative phases of patient care.
Currently the ASA grading system is used in Cleveland clinic to describe physical state of the patient and relates to anesthesia and surgery but due to dynamics of patients, health and unreliability of the system (could not classify a case where an individual was suffering from two diseases simultaneously), also currently, the process is staged with each stakeholder performing their particular responsibilities but lacking a systematic approach to sharing information.
Inadequate information is available for the process, therefore nurses in the clinic proposed for another upgraded information system. This decision was propelled by factors like surgery specific risks, surgery delays and postponement, functional capacity which accounted for the high mortality rate in the clinic. According to Zambouri (2007), many epidemiological studies show that inadequate preoperative preparation may be a factor contributing to causes of perioperative mortality.
However two barriers to implementation of this technology in Cleveland clinic are cost of creating a more integrated system of perioperative information sharing. The cost barrier can be managed through cost savings analysis of current practices. The second barrier to implementation rests on the integration of information sharing (Britt, 2005). Stakeholder realization must take place throughout the patient care process which recognizes the need for perioperative information sharing.
References.
Britt R. Hospitals and doctors lag behind information age. Live Science 15 March 2005. Available at: www.livescience.com/health/050315_medical_info.html. Retrieved July 12, 2013.
Borycki, E. M., Kushniruk, A., Keay, E., Nicoll, J., Anderson, J., & Anderson, M. (2009). Toward an integrated simulation approach for predicting and preventing technology- induced errors in healthcare: implications for healthcare decision-makers. Healthcare Quarterly Toronto Ont, 12 Spec No Patient, 90-96. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19667784
Brown, S., & Brown, J. (2011). Why do physicians order unnecessary preoperative tests? a qualitative study. Retrieved from http://www.stfm.org/fmhub/fm2011/May/Steven338.pdf
Jacques, P., & Minear, M. (2012). Improving perioperative patient safety through the use of information technology. Retrieved from http://www.ahrq.gov/professionals/quality- patient-safety/patient-safety-resources/resources/advances-in-patient-safety- 2/vol4/Advances-StJacques_105.pdf
US Department of Health and Human Services (2011) Nationwide Health Information Network:
Overview Retrieved from http://healthit.hhs.gov/portal/server.pt?open=512&objID=1142&parentname=Communit yPage&parentid=4&mode=2
Zambouri, A. (2007, January). Preoperative evaluation and preparation for anesthesia and surgery. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464262/
