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Using physiological monitoring data for performance feedback: an initiative using thermoregulation metrics

Overview of attention for article published in Canadian Journal of Anesthesia/Journal canadien d'anesthésie, October 2016
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Title
Using physiological monitoring data for performance feedback: an initiative using thermoregulation metrics
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, October 2016
DOI 10.1007/s12630-016-0762-3
Pubmed ID
Authors

Matthias Görges, Nicholas C. West, Simon D. Whyte

Abstract

Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management. We hypothesized that feedback on thermoregulation metrics, without changes in policy, could reduce temperature-monitoring delays at the start of scoliosis correction surgery. Although our tertiary pediatric centre does not have an anesthesia information management system, vital signs for all surgical cases are recorded in real time. Temperature data from children undergoing spine surgery are extracted from a vital signs databank and analyzed using MATLAB. Spine team anesthesiologists are provided with both team and individualized feedback regarding two variables: the percentage of time that patients are hypothermic and the time delay from the start of the case to the first temperature monitoring (our primary outcome). These data are shared every six months as run charts for the entire group and as anonymized (coded) box-and-whisker plots for each anesthesiologist. This feedback of temperature-delay data reduced the median [interquartile range] delay from 39.0 [18.7-61.5] min to 14.4 [10.8-22.9] min (median reduction, 21.8 min; 95% confidence interval, 14.9 to 28.2; P < 0.001). It did not, however, further reduce the percentage of time patients remained hypothermic beyond the improvements already achieved with prewarming. Feedback of intraoperative thermoregulation management improved both group and individual performances as measured by significant, sustained reductions in temperature-monitoring delays. Thus, intraoperative vital signs data may improve the quality of, and reduce the variability in, anesthetic practice.

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Geographical breakdown

Country Count As %
Unknown 5 100%

Demographic breakdown

Readers by professional status Count As %
Other 2 40%
Student > Ph. D. Student 1 20%
Student > Master 1 20%
Unknown 1 20%
Readers by discipline Count As %
Arts and Humanities 1 20%
Biochemistry, Genetics and Molecular Biology 1 20%
Agricultural and Biological Sciences 1 20%
Unknown 2 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 March 2017.
All research outputs
#17,283,763
of 25,371,288 outputs
Outputs from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#2,319
of 2,876 outputs
Outputs of similar age
#207,311
of 321,027 outputs
Outputs of similar age from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#28
of 37 outputs
Altmetric has tracked 25,371,288 research outputs across all sources so far. This one is in the 21st percentile – i.e., 21% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,876 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one is in the 13th percentile – i.e., 13% of its peers scored the same or lower than it.
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We're also able to compare this research output to 37 others from the same source and published within six weeks on either side of this one. This one is in the 18th percentile – i.e., 18% of its contemporaries scored the same or lower than it.