Typically, it takes years to complete a clinical PDSA cycle. However, by employing the new AI-based technology, our team was able to complete improvement cycles in just 12 weeks. Utilizing real-world data routinely collected in electronic medical records (EMRs), our team monitored and evaluated the comparative effectiveness of current and historical protocols on an ongoing basis. As a result, our team was able to quickly adapt our protocols, incorporating evidence-based best practices to effectively manage surgical pain while reducing patients’ opioid exposure.
Following this initial success, the BCSC’s clinical team expanded our approach to include other surgeries across a range of disciplines, including orthopedics, urology, plastics, dental, ophthalmology and general surgery. The results were groundbreaking. We developed protocols that eliminated the use of opioids during surgery from the vast majority of our outpatient procedures (dropping from 84% to 8% of procedures), while also reducing the need for postoperative morphine administration from 11% to just 6%. To date, over 6,000 patients have now successfully undergone surgery at BCSC without opioids.
With these new opioid-limiting protocols, we found that post-surgery nausea and vomiting, caused by opioids, virtually disappeared. In addition, pain scores, total anesthesia time, and total post-anesthesia care unit (PACU) time remained stable. Overall, costs also decreased (85% reduction in cost for analgesic medications), while patient/parent satisfaction increased dramatically.
This quality improvement initiative powerfully demonstrates how the healthcare industry can leverage digitized data and AI-based technology to improve patient care, patient safety, and operational efficiency.
About the author: Dr. Latham is a pediatric anesthesiologist and director of pediatric cardiac anesthesiology at Seattle Children's Hospital and has authored many publications on advances in anesthesiology and healthcare improvement. He also serves as an associate professor of Anesthesiology and Pain Medicine at University of Washington. Dr. Latham earned his MD at the University of Kansas.
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