Improving Perioperative Patient Safety Through the Use of Information Technology

The perioperative care process is a unique and challenging environment. Perioperative clinicians are increasingly focused on how to improve patient safety. Proven software design approaches and standards are available. If they are focused on the challenges in the perioperative environment, they can be an important catalyst to transform surgical care. Opportunities abound for informatics-based improvements in perioperative care. Additional perioperative work groups and industry partnerships need to be created. Health care standards should be reviewed to ensure full support of perioperative requirements. The complexities of the perioperative environment make technology implementation challenging, and the unique issues in this environment must be addressed when technology is deployed. There is a growing focus on the importance of technology use within health care. Too often the vision and priorities of national health care technology modernization efforts have not focused on the unique requirements of perioperative care. Perioperative Care: A Unique Environment The perioperative arena is a unique environment that includes many challenging variables: complex clinical care performed by teams; high cost, sophisticated technologies that often do not interoperate; and a large array of supplies, instruments, and implants that are difficult to manage. These variables create an environment of massive complexity and, unfortunately, are a source of a significant percentage of patient safety-related adverse events. The types of errors that can occur during the surgical process—patient misidentification, surgical site misidentification, and medication errors and omissions—are all more likely to occur, given the combination of high complexity and poor use of technology. The information technology (IT) sophistication offered to the perioperative environment does not match the requirements of clinicians, administrators, and even clerical staff. Surgical information systems have not kept pace with the demands of the perioperative process and still generally only provide basic functionality in the areas of patient/case scheduling, case planning and management, staffing, OR suite management, nursing perioperative documentation, and charge collection for hospital billing. Little attention has been given to physician (surgeon or anesthesiologist) clinical documentation, professional fee charging, surgical suite medication administration and documentation, or to integrating the information and technologies available throughout the perioperative environment.