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Quality Outcomes in Regional Anesthesia

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Olivia Beane

on 27 July 2013

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Transcript of Quality Outcomes in Regional Anesthesia

ExaminingQuality
Outcomes
in Regional
Anesthesia

* Majority of research on the efficacy of regional anesthesia has emphasized clinically-oriented, patient-related outcomes

* Lack of research regarding the consequences of regional anesthesia & post-op analgesia on nontraditional patient outcomes

* Outcomes research seeks to understand the end results of particular health care practices and interventions

* By linking the care people get to the outcomes they experience, outcomes research has become the key to developing better ways to monitor and improve the quality of care
-Agency for Healthcare Research & Quality
STRENGTH OF EVIDENCE
TYPES OF DATA & DATA ANALYSIS
*Kimberly Salvato
*Olivia Beane
*Jennie Sirk
*Joy Wallace
*Grace Medastin
Presented by:
OUTCOMES RESEARCH &
REGIONAL ANESTHESIA

AQI DATA INPUT
TYPES OF PATIENT-RELATED OUTCOMES IN REGIONAL ANESTHESIA
* Mortality
* Major morbidity
- Cardiovascular
- Coagulation
- Cognitive
- Gastrointestinal
- Immune
- Pulmonary
- Stress response
WHAT IS OUTCOMES RESEARCH?
* Health-related quality-of-life measurements
* Patient satisfaction
* Economic outcomes
-Types of costs and benefits:


direct & indirect, medical & non-medical
-Type of analysis:


cost-effectiveness, cost-benefit, cost-utility
-Perspective for analysis:

patient, payer, provider, societal
* Methodological issues with available
studies in regional anesthesia
- Inadequate sample sizes
- Use of surrogate endpoints
- Lack of incorporation of appropriate
postoperative analgesia regimens
- Inadequate assessments of pain
- Limited ability to apply results of
randomized, controlled trial to a
more generalized population
CURRENT STATUS OF OUTCOMES RESEARCH IN REGIONAL ANESTHESIA
* Overall mortality & morbidity
* Coagulation
* Gastrointestinal
* Pulmonary
* Cardiovascular
* Stress response
* Immune function
* Cognitive function
CURRENT OUTCOMES DATA
Anesthesia Quality Institute (AQI)
DATABASES FOR REGIONAL OUTCOMES
Institute for Clinical Systems Improvement
Cochrane
Collaboration
Agency for Healthcare Research & Quality
Society for Ambulatory Anesthesia (SAMBA)
Multicenter Perioperative Outcomes Group (MPOG)
* The AQI, working with various ASA and subspecialty society committees, will define data and outcomes that are collected in NACOR, will provide unifying definitions and templates, will contract with individual practices and hospitals to exchange data, and will be responsible for reporting the data collected.

* Individual anesthesia practices, hospitals, and providers will provide data to NACOR and will use the reports they get back to improve patient care and meet various local, state and federal regulatory requirements.

* Vendors of anesthesia information technology will facilitate NACOR reporting through their work with individual practices. Vendors that provide formatted data for contribution to NACOR will be listed as AQI Preferred Vendors on the AQI website.
AQI
* The desired data falls into four broad categories:
1. Practice demographics
2. Case specific data in several . tiers
3. Outcomes data
4. Risk adjustment data
AQI DATA
AQI
REGISTRY DATA
AQI DATA OUTPUT
RESOURCES
* Cochrane
* Pubmed
* CINAHL
* Google
* Up-to-date
GOOGLE SEARCHES
* "Quality outcomes in regional anesthesia for..... surgery''

* "Regional anesthesia quality outcomes for.... surgery''

* "Regional anesthesia outcomes''

* Measuring regional anesthesia outcomes in.... surgery''

* ''Assessing outcomes of regional anesthesia''
* www.raadvantages.com
Quality Outcomes in Regional



Anesthesia for Cataract Surgery
COCHRANE LIBRARY
PubMed
raadvantages.com
raadvantages.com
ANESTHESIA JOURNALs
PAIN JOURNALS
ARTICLES-REVIEWS
COCHRANE LIBRARY
COCHRANE LIBRARY
OTHER SOURCES
QUESTIONS?
THANK YOU!
“NONTRADITIONAL” OUTCOMES
Clinically oriented or “traditional” outcomes
Clinical outcomes:
CURRENT OUTCOMES DATA
Nontraditional outcomes:
* Economic outcomes and . analysis
* Health-related Quality of Life . measurements (HRQL)
* Patient satisfaction
ANESTHESIA QUALITY INDICATORS
AQI PATIENT ASSESSMENT TOOL
ANESTHESIA QUALITY IMPROVEMENT TOOL
http://www.raadvantages.com/anesthesia/
Full transcript