Problem

Cases are found on Day of Surgery to have been mis-identified at some point in the process between the point of Scheduling

Request and Registration.Result

Preparatory efforts for Day of Surgery are for the wrong patient, recorded on the

wrong patient, integrated for the wrong patient, creating delays and potential risk in

the delivery of care.

Increasing Deployment of integrated systems for providing Peri-Procedural and Peri-Surgical care

•Scheduling of all resources and the initiation of planning – it all starts here•Clinical documentation - Prior to Arrival efforts, Pre Anesthesiology, Pre Nursing, Intra Anesthesiology, Intra Nursing, Post Anesthesiology , Post Nursing•Hospital Billing, Anesthesiology Billing•Reporting

SLCHBWCCPAP

IVF, GI,

ECT, MRI, CPC, Rad, etc.

North South L&D

OC

195 Cases on a given day

84/195 Seen in CPAP within 30 days101/195 Intubations67/101 Intubations Seen in CPAP38 Inpatient > DOS

63

17

68

26

33

21

31

20

Number ScheduledNumber Seen in CPAP

Opportunity days between planning and occurrence

5 and under

6 to 14

15 to 30

30 or more

The Anesthetic PlanA preanesthetic evaluation allows for the development of an anesthetic

plan, and preparatory testing, that considers all procedural risk and conditions or diseases of the patient that may influence the safe outcome

of the anesthetic.

Case posts in the MetaVision (PreAdmission state which is Inactive) if a MRN is in the Scheduling Message and if not it will post when the MRN

shows up in the Registration Message.

IF Active - Automatically pulls in Past Medical and

Past Surgical History from Previous MetaVision

visit

IF Active - Automatically pulls in

recorded Allergies from Previous visit

IF Active - Automatically imports Last

documented Home Medication, Smoking and Alcohol history,

OSA, Difficult Intubation , Nursing

History.

Labs InterfaceLab message to MetaVision:

Match by MRN. If MRN does not match

delete.

IMPLICATIONSBlood Bank and

Lab results only if MRN

Match. Scheduling errors will

result in failure to post

Manual Import of

PAP if greater than 30

days

Clinician review of Clindesk,

Labs, History, record

findings and plan in

MetaVision.NOTE Just

opening the record in

MetaVision, regardless of

Status, requires

forever save because of

HIPAA

What it takes for Surgical/Procedural Case progression

Documenting

executed care on DOS.

Occurs prior to arrival as preparation or on DOS

ScheduledRegistration in advance of, or on,

DOSDOS

Case Inactive Case Active

End

Resu

lt in

terf

ace

d t

o:

Clin

desk

, ID

X A

nest

hesi

a,

SIS

H

osp

ital B

illin

g Inte

rface

, H

osp

ital D

ata

Ware

house

for

Sta

te r

eport

ing

Pri

mary

Offi

ce V

isit

Pitfalls to Anecdotal Thinking

Failure to ObserveAssuming you know what the problem is without

seeing what isactually happening

Failure to PlanAssuming you know how to fix a problem without first

findingout what is causing it

Failure to ValidateAssuming the action you have taken to fix the

problem hasworked without