Vanderbilt Anesthesiololgy

At Vanderbilt, over ninety-nine percent of surgeries are completed without anesthesiology-related complications. Even though we maintain this impressive track record, efforts are continually underway to improve our performance even further. It is the role of the Anesthesiology Quality Improvement Program to provide a routine, planned and systematic process to monitor and evaluate the quality and appropriateness of anesthesia care provided to patients at the Vanderbilt University Hospital and Vanderbilt Children’s Hospital.

A system of continuous quality improvement is in place which monitors key quality indicators, whether or not they lead to patient discomfort or require additional medical attention. These monitors include paper and electronic reporting of intra-operative irregularities such as unexpected responses to medication or therapy. Additionally, a series of postoperative telephone calls records several Indicators of patient satisfaction with their anesthesiology, nursing and surgical staff and state well-being.

To provide a mechanism to resolve problems and /or potential problems identified by the process of monitoring and evaluation, data is handed in a confidential manner to departmental peer review committees where each issue is discussed and analyzed by a team of physicians. Any issues which require further discussion or which might indicate a need for change in usual practice are referred to the department’s central Quality Improvement Committee. In addition to this type of analysis, the Quality Improvement Committee also reviews proposed changes to standard practice, requests from other departments for information regarding standard practice, and proposed new technology implementation. Standard monthly reports are distributed to physicians in the department analyzing group practice and performance on indicators of patient satisfaction and safety. Reports on the quality of perioperative care are made on a regular basis, to the VUH Executive Safety Committee, the Quality Council and the Medical Center Medical Board. By this mechanism we are most able to ensure that our patients have as safe and pleasant an experience as is possible.

The Purpose of the Anesthesiology QI Program

The Anesthesiology QI program was started in 1981. Tools were developed to measure the quality of care. These manual tools were converted to the computer program in 1995. Day Surgery patients began being called on a consistent basis in 1996. The ambulatory care centers use the telephone interviews to track problematic attempts to reduce nausea and vomiting or other symptoms as result of receiving anesthesia.

Sharing the positive comments made about praising the efforts of caregivers:

• Has an obvious value of encouraging top notch performance
• Encourages others to make similar efforts

The negative comments serve as:

• Damage control efforts since problems are solicited and resolved prior to having normal complaint mechanisms involved.
• Better yet, the QI Office gets negative complaints that wouldn’t even get in the “normal” complaint system, but still have significant PR implications, if left unsolved.

Data gathered provides excellent baseline data for further studies to improve the quality of care.

For additional information, please contact the departmental quality improvement team at (615) 936-1080.

Vanderbilt Anesthesiology
Department of Quality Assurance
Medical Arts Building, Room 705
1211 21st Ave S., Nashville TN 37212
Tel: (615) 936-1080 Fax: (615) 936-2801
Email: sue.walsh@vanderbilt.edu