Joshua Berris No conflicts to disclose
ASPIRE/EPIC data &
Questionnaires
Practice Improvement
& Reporting
2
When We Last
Talked…
3
CHRONICLES
Everyday user experience.
Only Epic can do analysis
CLARITY
Relational Database
Not used for routine queries
Press Ganey
Data
FH Quality
Data
Anes. Dashboard
CRNAs & MDAs
Monthly
OR Performance
Managers & Director
Daily
ASPIRE Audit
CRNAs & AQCRs
Daily
Med. Admin
OPPE & FPPE
Monthly
Quality
Committee
Quarterly
Add
More
Data
Combined
Data Warehouse
Multiple other
reports &
dashboards
FH ASPIRE
Data
Add More
Data
CHRONICLES
Everyday user experience.
Only Epic can do analysis
CLARITY
Relational Database
Not used for routine queries
Press Ganey
Data
FH Quality
Data
Anes. Dashboard
CRNAs & MDAs
Monthly
OR Performance
Managers & Director
Daily
ASPIRE Audit
CRNAs & AQCRs
Daily
Med. Admin
OPPE & FPPE
Monthly
Quality
Committee
Quarterly
Add
More
Data
Combined
Data Warehouse
Multiple other
reports &
dashboards
FH ASPIRE
Data
Add More
Data
Now there is more…
CHRONICLES
Everyday user experience.
Only Epic can do analysis
CLARITY
Relational Database
Not used for routine queries
Press Ganey
Data
FH Quality
Data
Anes. Dashboard
CRNAs & MDAs
Monthly
OR Performance
Managers & Director
Daily
ASPIRE Audit
CRNAs & AQCRs
Daily
Med. Admin
OPPE & FPPE
Monthly
Quality
Committee
Quarterly
Add
More
Data
Combined
Data Warehouse
Multiple other
reports &
dashboards
FH ASPIRE
Data
Add More
Data
Now there is more…
We included Surgeons
CHRONICLES
Everyday user experience.
Only Epic can do analysis
CLARITY
Relational Database
Not used for routine queries
ERAS
Information
Press Ganey
Data
FH Quality
Data
Add
More
Data
Anes. Dashboard
CRNAs & MDAs
Monthly
OR Performance
Managers & Director
Daily
ASPIRE Audit
CRNAs & AQCRs
Daily
Med. Admin
OPPE & FPPE
Monthly
Quality
Committee
Quarterly
Add
More
Data
Combined
Data Warehouse
Multiple other
reports &
dashboards
FH ASPIRE
Data
Add More
Data
What was the need
• Time, money, personnel dedicated to ERAS
– How do we show impact to
• Administration
• Surgeons
• Anesthesiologists
• CRNAs
• IT support is a limited resource
What was the problem
• Need to get non-EMR data into electronic
reportable form
• Need to extract EMR data into electronic
reportable form
• Need a method to report
Problem already solved
Need to get non-EMR data into electronic
reportable form – Scan Tron
Need to extract EMR data into electronic
reportable form – Reporting extract Clarity
Need a method to report – Excel + VBA
Solutions
• Non-EMR data
– Patient diary data
– Human extracted data points
• Bubble Sheets
– Remark Office OMR
• Existing structure
for other info.
Resolution
Resolution
• Individualized
dashboard sent to
each surgeon
monthly
• Surgeon and department
performance for this year
and last year
Conclusion
• We collect a large amount of data on our ERAS
population
• We now organize that data and push it to
surgeons, administrators and anesthesia
providers
Conclusion
• Does ERAS make a difference?
– LOS prior to ERAS Colorectal
• 8.8 days
– LOS after ERAS Colorectal
• 4.2 days
• BUT…
Conclusion
PreOp
Education
0.01
Antibacterial
Shower -
0.04
Liquid Carb
Loading
0.13
Smoking Status
-
0.21
30
day Readmission -
0.12
PONV
Prophylaxis
0.05
PONV
0.04
Morphine mcg/kg/min
0.19
ABX
Prophylaxis Given
0.11
Liquid
Starting Day 0
0.20
Liquid
Starting Day 1
0.01
Liquid
Starting Day 2
0.10
Liquid
Starting Day >3 -
0.42
Fluid
total POD 0
0.16
Fluid
total POD 1
0.15
Fluid
total POD 2
0.26
NG
Removed IntraOp
0.22
Foley
Removed POD0
0.15
Foley
Removed POD1
0.23
Foley
Removed POD2 -
0.06
Foley
Removed POD>3 -
0.38
Pain
<4, PACU Discharge
0.08
• Correlation between LOS
Conclusion
PreOp
Education
0.01
Antibacterial
Shower -
0.04
Liquid Carb
Loading
0.13
Smoking Status
-
0.21
30
day Readmission -
0.12
PONV
Prophylaxis
0.05
PONV
0.04
Morphine mcg/kg/min
0.19
ABX
Prophylaxis Given
0.11
Liquid
Starting Day 0
0.20
Liquid
Starting Day 1
0.01
Liquid
Starting Day 2
0.10
Liquid
Starting Day >3 -
0.42
Fluid
total POD 0
0.16
Fluid
total POD 1
0.15
Fluid
total POD 2
0.26
NG
Removed IntraOp
0.22
Foley
Removed POD0
0.15
Foley
Removed POD1
0.23
Foley
Removed POD2 -
0.06
Foley
Removed POD>3 -
0.38
Pain
<4, PACU Discharge
0.08
• Correlation between LOS
• But that’s not exactly
what this talk
is about.
