Implementation of a standardised questionnaire for documenting preoperative respiratory illness in paediatric patients

• Published in: BMJ open quality Vol. 13; no. 4; p. e002843
• Main Authors: Winterberg, Abby Victoria, Richmond, Stacie, Tighe, Nathaniel T G, Buckley, Jennifer, Buck, David Winthrop
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 18.10.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Anaesthesia; Child; Colds; Decision making; Documentation; Documentation - methods; Documentation - standards; Documentation - statistics & numerical data; Electronic health records; Humans; Nurses; Paediatrics; Patients; Pediatrics; Pediatrics - methods; Pediatrics - standards; Pediatrics - statistics & numerical data; Preoperative Care - methods; Preoperative Care - standards; Preoperative Care - statistics & numerical data; Preoperative Period; Quality Improvement; Questionnaires; Respiration Disorders - etiology; Respiratory diseases; Respiratory Tract Diseases; Short Report; Surgeons; Surgery; Surveys and Questionnaires; Anaesthesia; Quality improvement; Surgery; Paediatrics
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2024-002843

Paediatric patients often present with symptoms of respiratory illnesses in the weeks leading up to surgery. Current or recent illness can increase the risk of experiencing perioperative respiratory complications. Ideally, children with recent illnesses should be identified before coming to the hospital to determine the safest course of action. We recognised that our system lacked a standardised process for documenting preoperative respiratory illness during the preoperative phone call. The global aim of this quality improvement initiative was to decrease paediatric perioperative respiratory adverse events. The SMART Aim (Specific, Measurable, Achievable, Relevant and Time-bound) was to increase the percentage of patients with standardised documentation of preoperative respiratory illness from 0% to 90% by 1 March 2023. Implementation of a standardised preoperative illness questionnaire increased standardised illness documentation from 0% to 95%. Nurses quickly adopted this intervention and easily integrated it into their routine workflow. Clinical leaders elected to implement the intervention electronically across all three operating room (OR) locations (main OR, satellite location and procedure centre). Future implementation of additional standardised preoperative processes will be needed to improve the global aim of decreasing perioperative respiratory complications.