Compliance Is Contagious: Using Informatics Methods to Measure the Spread of a Documentation Standard From a Preoperative Clinic

J Perianesth Nurs. 2018 Aug;33(4):436-443. doi: 10.1016/j.jopan.2016.08.016. Epub 2017 May 13.


Purpose: Preoperative documentation is essential to coordinated care and has the potential for standardization, which may facilitate downstream clinical management.

Design: An observational pre/post standardization design was used.

Methods: We analyzed the implementation of a preoperative documentation standardization intervention in Vanderbilt's Preoperative Evaluation Clinic (VPEC) and its impact outside VPEC. A phased intervention consisted of clinician education with monthly feedback, followed by the development of a compliance dashboard and inclusion in Ongoing Professional Performance Evaluation system by VPEC. A follow-up survey was administered to measure the impact on clinical management.

Findings: Adherence to standardization was improved with the addition of electronic feedback. Implementation of this system in the preoperative clinic had significant impact outside VPEC. Trainee status was a significant predictor of adoption of the standardized format.

Conclusions: Adoption of a preoperative documentation standard in a clinic had a positive impact on standardization practices in a perioperative system.

Keywords: history of present illness; informatics; preoperative evaluation; standardization.

MeSH terms

  • Ambulatory Care Facilities / standards*
  • Documentation / standards*
  • Guideline Adherence*
  • Humans
  • Preoperative Care*