Quality Improvement Research

Quality and Process Improvement/Patient Safety

The Department of Anesthesiology Quality Council, composed of Quality Directors from each clinical service, oversees quality improvement activities and the implementation of new processes to improve patient care and clinical outcomes. Some of the projects currently underway include prevention of intraoperative hypothermia and hyperglycemia, identification and optimizing care of patients with obstructive sleep apnea, improved blood ordering, timely administration of perioperative antibiotics, and use of multimodal therapies to prevent postop nausea and vomiting. Faculty members are actively working as part of multidisciplinary teams on projects to reduce complications like surgical site infections and to improve surgical outcomes like the Enhanced Recovery After Surgery (ERAS) program for colorectal surgery patients. To ensure the effectiveness of our initiatives, we regularly access information from the clinical data warehouse and participate in the American Society of Anesthesiologists National Anesthesia Clinical Outcomes Registry.

Process improvement examines how the way we do business affects patients, staff, and healthcare providers and seeks to increase satisfaction, decrease costs, and reduce waste by changing how we deliver healthcare. We are industry-leading by having dedicated faculty and staff who are tackling some of the most challenging issues in a rapidly-changing healthcare landscape.

Examples of how anesthesiologists are improving the patient care experience and reducing cost are:

  • An evaluation of intraoperative transfusions over a 2 ½ year period demonstrated that excessive laboratory screening tests were being ordered. In collaboration with the Grady Blood Bank, a Maximum Blood Ordering Schedule was developed, saving approximately $65,000 a year. Because of this success, the project is now being expanded into Perioperative Services at Emory University Hospitals and in Liver Transplants for additional anticipated resource savings.
  • The Department of Anesthesiology in conjunction with the Director of the Emory Sleep Center has created a detailed process for the screening and anesthetic management of surgical patients with known or suspected obstructive sleep apnea (OSA). To identify patients that may have OSA but not diagnosed, the Anesthesia Pre-Operative Clinic is screening all patients for a history of sleep apnea or characteristics and behaviors associated with the condition. The anesthesiologist caring for the patient in the operating room uses the information obtained during the pre-operative visit to tailor a safe and personalized anesthetic for patients on the day of surgery. Additionally, an anesthesiologist in the Post-operative Care Unit provides care for these patients to initiate appropriate treatment after surgery to improve outcomes and prevent respiratory complications.

Our goals are to optimize patients’ medical conditions prior to surgery, provide individually planned anesthetics for patients on the day of surgery, and working with surgeons and other team members, provide safe post-operative care to ensure a healthy recovery.