How the Cleveland Clinic uses IT to Help Anesthesiologists Improve Patient Safety

One example of the Cleveland Clinic's increasing use of digital technology is the electronic reminders it sends to anesthesiologists to carry out a patient safety task, according to Marc Harrison, MD, chief medical operations officer at the clinic.

Research has shown that an antibiotic administered to a surgery patient within one hour before the operation can prevent surgical site infections. These infections lengthen hospital stays, cause readmissions and increase patient mortality. But Dr. Harrison says busy anesthesiologists can sometimes forget to carry out the task.

So a few years ago, patient safety personnel decided to set up the clinic's IT system to monitor this task and send reminders those anesthesiologists not carrying it out.

Anesthesiologists at the clinic are regularly at a computer screen doing a variety of tasks, such as recording their tasks in the patient's medical record. They tell the computer when they have administered antibiotics and the information goes into the clinic's electronic database, Dr. Harrison says. A monitoring system queries the database in real time to determine if the antibiotic was administered and at what time, because poor timing affects potency of the dose. If the task is not carried out in a timely manner, a reminder automatically appears on the anesthesiologist's computer screen.

For the alerts to work, Dr. Harrison says department heads have to meet with physicians, tell them about the system and explain why it's important. "The physicians can self-manage because they want to do the right thing," he says. "This works because physicians are data-driven, they are goal-oriented and competitive.

Since the reminder system was installed about two or three years ago, compliance with the safety directive has risen from 75-80 percent to 100 percent, Dr. Harrison says.

Last fall, the clinic introduced a similar electronic alert reminding caregivers to stop giving antibiotics within 24 hours after surgery, which is another patient safety measure. Compliance for that measure has risen from 90 percent to 100 percent.

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