title: Creation of an integrated outcome database for pediatric anesthesia.
abstract: Outcome analysis is essential to health care quality improvement efforts. Pediatric anesthesia faces unique challenges in analyzing outcomes. Anesthesia most often involves a one-time point of care interaction where work flow precludes detailed feedback to care givers. In addition, pediatric outcome evaluations must take into account patients' age, development, and underlying illnesses when attempting to establish benchmarks. The deployment of electronic medical records, including preoperative, operative, and postoperative data, offers an opportunity for creating datasets large and inclusive enough to overcome these potential confounders. At our institution, perioperative data exist in five distinct environments. In this study, we describe a method to integrate these datasets into a single web-based relational database that provides researchers and clinicians with regular anesthesia outcome data that can be reviewed on a daily, weekly, or monthly basis. Because of its complexity, the project also entailed the creation of a 'dashboard,' allowing tracking of data trends and rapid feedback of measured metrics to promote and sustain improvements. We present the first use of such a database and dashboard for pediatric anesthesia professionals as well as successfully demonstrating its capabilities to perform as described above.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Cravero
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.|Department of Anesthesiology, Siriraj Hospital, Bangkok, Thailand.
authors.forename: Patcharee
authors.initials: P
authors.lastname: Sriswasdi
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lekowski
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Carpino
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Blum
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Nissa
authors.initials: N
authors.lastname: Askins
authors.affiliation: Department of Biostatistics, Boston Children's Hospital, Boston, MA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Sinnott
mesh_terms: D000293:Adolescent; D000758:Anesthesia; D000776:Anesthesiology; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020407:Internet; D010372:Pediatrics; D016896:Treatment Outcome; D055815:Young Adult
keywords: data aggregation; outcome and process assessment; pediatric; perioperative care; quality improvement