Dissemination of Patient Centered Outcomes in Anesthesia Care The rate of serious complications from anesthesia is low, but not zero. Complications that affect patient comfort, such as inadequate pain management or perioperative nausea and vomiting, are common and disturbing occurrences. Safety and comfort determine patient satisfaction with anesthesia care, and patient willingness to undergo procedures. Patients who experience adverse outcomes require additional resources and decrease the efficiency of healthcare. The American Society of Anesthesiologists (ASA) is the largest provider of continuing medical education for anesthesiologists in the world, and an important source for public education. The Anesthesia Quality Institute (AQI) was created by ASA to improve perioperative care through development of the National Anesthesia Clinical Outcomes Registry (NACOR). The AQI recruits anesthesia practices to submit administrative, clinical and outcome data;150 practices participate in NACOR, representing more than 10% of anesthesiologists and surgical facilities in the US. NACOR includes more than 4 million cases now and will double in size within the year. An opportunity exists to improve patient-centered anesthesia outcomes, using AQI data to identify gaps in care that can be filled with ASA educational materials for patients and providers. NACOR will be used to create benchmarks for measures of patient satisfaction with anesthesia. Data will be analyzed to determine the variation in outcomes across providers and to identify high and low outliers. Identification of outcome variation will lead to creation of bundles of ASA educational material based on best practices, to close identified gaps in knowledge. Educational materials and ongoing performance reports will be deployed to AQI practices and providers. In addition, gap analysis will lead to educational media targeted at patients themselves, with a focus on what the patient can do to improve their own safety and comfort in the perioperative period. Changes in patient-centered outcomes will be tracked over time, with assessment of which educational interventions are most effective at the patient, provider and practice level.
Millions of patients each year undergo anesthesia, with varied degrees of safety and satisfaction. The proposed research will use data from the National Anesthesia Clinical Outcomes Registry to identify targets for improvement through better education of patients and providers. The American Society of Anesthesiologists will develop these materials and distribute them to registry participants and their patients. This focus on patient-centered outcomes will result in better care and improved satisfaction in all patients who undergo surgical procedures.