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TECHNOLOGY, COMPUTING, AND SIMULATION

An Anesthesia Information System Designed to Provide Physician-Specific Feedback Improves Timely Administration of Prophylactic Antibiotics

Michael O’Reilly, MD, MS^*, AkkeNeel Talsma, PhD, RN, Sharon VanRiper, MS, RN, Sachin Kheterpal, MD^*, and Richard Burney, MD

From the *Department of Anesthesiology, Office of Clinical Affairs, Corporate Quality Improvement, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.

Address correspondence and reprint requests to: Michael O’Reilly, MD, Department of Anesthesiology, University of Michigan Health Systems, 1500 E Medical Center Dr., Room UH1H247, Ann Arbor, MI 48109-0048. Address e-mail to oreilly{at}umich.edu.

Surgical site infections are a frequent cause of morbidity and mortality and add significantly to the cost of care. One component of the national Surgical Infection Prevention (SIP) program is to ensure timely administration of prophylactic antibiotics, a key factor to reduce postoperative infection. Our anesthesia department decided to assume the responsibility for timing and administration of antibiotic prophylaxis and we initiated a multitiered approach to remind the anesthesiologist to administer the prophylactic antibiotics. We used our anesthesia clinical information system to implement practice guidelines for timely antibiotic administration and to generate reports from the database to provide specific feedback to individual care providers with the goal of ensuring that patients receive antibiotic prophylaxis within 1 h of incision. Before the initiation of this project, 69% of eligible patients received antibiotics within 60 min of the incision. After the program began, there was a steady increase in compliance to 92% 1 yr later. Provider-specific feedback increases compliance with practice guidelines related to timely administration of prophylactic antibiotics. Anesthesia information systems hold promise for implementing and monitoring new practice guidelines and the anesthesiologist may play a key role in influencing surgical outcomes by ensuring appropriate therapy that may not be directly related to anesthesia care.

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