EXTRACORPOREAL MEMBRANE OXYGENATION
The James and John Kirklin Institute for Research in Surgical Outcomes ( KIRSO ) was established to build a comprehensive , multidisciplinary institute focusing on surgical outcomes research and database development , in order to analyze and improve outcomes of surgical therapies and their impact on patients . The utilization of extracorporeal membrane oxygenation ( ECMO ) therapy has exploded globally , outpacing the ability for researchers to evaluate , analyze , and disseminate clinical outcomes in a timely and efficient manner . Therefore , UAB Medicine partnered with KIRSO to develop a UAB ECMO Patient Care Database for daily patient management , quality assurance ( QA ), and quality improvement ( QI ). The partnership between KIRSO and the UAB ECMO team resulted in the development of an innovative data repository that aids in quality initiatives and helps transform care at the bedside .
The cornerstones of the database are interfacing with the electronic medical record to ensure near-real-time data access and collaborating with the clinical care team to determine the clinical information required for decisionmaking while caring for the patient . The evolution of the database has transformed day-to-day care by presenting values of predetermined critical parameters visualized upon a single-screen display and identifying and tracking adverse events that are defined and adjudicated . At the patient level , individual values can be trended in a graphical display that includes medical history , adverse events or complications , and device utilization . It also includes customizable reporting tools that save many hours of work by generating reports for hospital QA and QI processes .
EXTRACORPOREAL MEMBRANE OXYGENATION
Coming soon are predictive models ( based on an analysis of over 400 UAB ECMO patients ) embedded in the database system that will generate patient-specific predictions of survival before and during ECMO therapy .
BENEFITS OF THE UAB ECMO PATIENT CARE DATABASE What it is transforming :
• The display and tracking of multiple parameters critical to patient care
• Identification and tracking of adverse events
• Real-time confirmation / adjudication at the bedside by the physician , certifying the accuracy / truth of the event
• Prediction of the effectiveness and futility of ECMO therapy using research-based predictive models
• Shared physician / family decisions using frequently updated models
• Facilitation of quality improvement initiatives by being a data reservoir that automates report generation for QA and QI “ on the fly ”
Future potential :
• A database tool that generates daily progress notes and discharge summaries that can be automatically populated with summaries of adverse events and other key data cataloged during sometimes lengthy and complex ECMO therapy sessions
In short , UAB ’ s pioneering efforts in cardiovascular surgical care are on full display with the development of the UAB ECMO Patient Care Database . uabmedicine . org 23