Written statement of the Association of periOperative Nurses (AORN by jasonpeters

VIEWS: 39 PAGES: 5

									                      Written statement
                            of the
        Association of periOperative Nurses (AORN)
       Patrick Voight RN BSN MSA CNOR; President
         Linda Groah RN MSN CNOR FAAN; CEO
                            To the
 Federal Coordinating Council for Comparative Effectiveness
                      Listening Session
                        April 14, 2009

        Department of Health & Human Services (DHHS)
                Hubert H. Humphrey Building
                       Washington, DC

Thank you for giving AORN the opportunity to address the Council on the very
timely and important issue of comparative effectiveness. We want to emphasize
three points:

1. Data collection from nursing sources is a critical element to inform
   effectiveness decisions;

2. Standardized data available from the point of patient care is essential to inform
   comparative analysis.

3. Syntegrity creates an opportunity for a national surgical data repository that
   could be used to measure quality outcomes and potentially be used for
   comparative effectiveness studies to decrease cost and improve quality.
Since the 1980’s the Association of periOperative Registered Nurses (AORN) has
been a pioneer in developing and promoting the Perioperative Nursing Data Set
(PNDS), a standardized language for documentation and evaluation of the care
provided in the operating rooms of our nation’s hospitals and ambulatory surgery
centers. As a 501( c)(6) association based in Denver, AORN represents over
43,000 registered nurses and has a history of patient centered safety and quality
activities.

The guiding premise of the PNDS effort was to assist perioperative nurses in
documenting the care they gave before, during and after the surgical procedure,
while providing a foundation for examining and evaluating the quality and
effectiveness of that care.

While effectiveness within a hospital or surgery center was informed by this data,
the ability for comparison between providers was rarely available because each
facility customized the PNDS to their environment.

In early 2008, AORN initiated the development of an electronic and standardized
perioperative framework referred to as Syntegrity.

This standardized perioperative framework is not intended to replace current
information and documentation systems, but is designed to be incorporated into
existing software. Most hospital surgical IT vendors already license AORN’s PNDS
but again, this is often customized for a specific facility. With the emphasis on
electronic and standardized data collection coming from the federal government, the
Syntegrity framework is poised to fill that emergent need.
AORN is acknowledged nationally as the association that establishes evidence
based standards and recommendations for care of the surgical patient. Syntegrity
incorporates these standards and recommended practices into the database. Thus,
Syntegrity creates an opportunity for a national surgical data repository that could
be used to measure quality outcomes and potentially be used for comparative
effectiveness studies to decrease cost and improve quality.
Here is a concrete example of how Syntegrity could be helpful for infection
prevention:

Syntegrity includes current CMS requirements for documentation on infection
prevention processes. This “pop up box” requires the nurse to document from the
choices in the electronic field or provide an explanation for any exception. This
standardized, electronic data capture now becomes available for a repository from
which specific analysis may be performed to measure the effectiveness of the CMS
requirement. It is important to emphasize that the data collection by the nurse is
already part of most surgical processes – what Syntegrity does is STANDARDIZE
the data collected in an ELECTRONIC format . This creates an opportunity for a
national surgical data repository that could be used to measure quality outcomes
and potentially be used for comparative effectiveness studies to decrease cost and
improve quality.


As further guidance to the Coordinating Council on the important priorities of
health reform that AORN believes are impacted by the consideration of
comparative effectiveness, we provide the following information and specific
AORN resources that are meaningful to this discussion.

Quality improvement must play an essential role in health care reform efforts
ensuring reform not only expands coverage, but also improves the care patients
receive.
   • AORN standards and recommended practices are a key resource. AORN is
      acknowledged nationally as the association that establishes evidence based
      standards and recommendations for care of the surgical patient. Syntegrity
      incorporates these standards and recommended practices into the database.
   • AORN’s Perioperative Nursing Data Set (PNDS) is a standardized language
      that facilitates the documentation and evaluation of the care provided by
      perioperative nurses.
   • AORN has embarked on an initiative to create a standardized perioperative
      framework (Syntegrity) that will be integrated into hospital and surgery center
      electronic perioperative information systems.
  • The essential role of the RN as Circulator and the value added of the
    registered nurse first assistant underscore the role of perioperative nurses in
    achieving quality and may be informed with comparative effectiveness
    analysis arising from data made available through Syntegrity data repository.

Performance measurement is a core building block to provide high quality
affordable care. Information that is grounded in good evidence will support quality
improvement, payment reform, and enable better clinical and consumer decision-
making. This information can tell us which care is leading to better outcomes and
which treatment options are more cost effective.
   • AORN supports the National Priorities Partnership convened by NQF
   • AORN supports Stand for Quality

Investment in health information technology should be linked to improving care.
Health information technology (HIT) represents an important means of advancing
quality measurement and improvement. But HIT can only help improve the quality
of care if it is designed to more effectively collect performance information.
   • AORN Syntegrity provides a standardized perioperative framework (SPF) that
      will be integrated into hospital and surgery center electronic perioperative
      information systems to provide evidence for quality improvement in the
      operating room.
   • Syntegrity creates an opportunity for a national surgical data repository that
      could be used to measure quality outcomes and potentially be used for
      comparative effectiveness studies to decrease cost and improve quality.

Performance measurement must be dramatically expanded, but measurement is not
enough. Expanded efforts on all fronts to foster greater use of performance
information to support clinical improvements and the delivery of more cost
effective care, expand public reporting, and expand the use of performance
information to promote changes in payment to promote value.


In conclusion, we want to emphasize three points:
• Data collection from nursing sources is a critical element to inform
  effectiveness decisions.

• Standardized data available from the point of patient care is essential to inform
  comparative analysis.

• Syntegrity creates an opportunity for a national surgical data repository that
  could be used to measure quality outcomes and potentially be used for
  comparative effectiveness studies to decrease cost and improve quality.


For further information from AORN or to set up an information briefing, contact Craig Jeffries, AORN Public Policy Consultant at
CJeffries@AORN.org.

								
To top