Clinical audit of nonoperative anaesthesia time and surgical site infections of canine tibial plateau osteotomy procedures.

Aims and objectives: The aim of this clinical audit was to reduce nonoperative anaesthesia time from 131 minutes to 102 minutes while maintaining surgical site infection rates below 10% for canine tibial plateau osteotomy procedures. Data collected from anaesthesia records and electronic medical records provided the data to measure these aims.

Background

Increased anaesthesia time increases the risk for perianaesthetic complications including surgical site infections. Through anaesthesia record analysis we recognised that nonoperative anaesthesia time was a variable that could be targeted for improvement. Nonoperative anaesthesia time is defined as total anaesthetic time minus surgical time.

Methods

Review of 40 total anaesthetic records (24 initial audit, 16 re-audit) and electronic medical records provided the data we recorded to determine anaesthesia time information and surgical site infection information. Manual audits were conducted to create a value stream map and nonoperative anaesthesia times were analysed for special cause variation utilising statistical process control.

Results

Nonoperative anaesthesia time was 131 minutes, roughly half of total anaesthesia time (270 minutes), while surgical site infection rate was 8.3%. Implementation of changes (team discussion & changes made): A new communication protocol was trialed between anaesthesia and surgical teams. Re-audit: The same procedure and analysis were used for the initial audit and re-audit. During the re-audit nonoperative anesthesia time was reduced to 109 minutes and surgical site infection rate was 6.3%. Application: The communication protocol trialed during the re-audit is still in practice. This audit can be applied to other practices looking to better analyse their anaesthetic time variables and to re-evaluate communication procedures for better patient outcomes.