This report was commissioned to explore and develop a standard for the anaesthetic chart, recognising its integral role in patient safety within the perioperative pathway.

Overview

Anaesthetics is the single largest UK hospital specialty, over two-thirds of hospital in-patients will see an anaesthetist and sixteen per cent of all hospital consultants are anaesthetists. 

The anaesthetic chart:

• Is integral to the real-time delivery of safe anaesthesia – acknowledgement of trends, variations, events, and actions is part of the process of giving an anaesthetic.
• Provides instantaneous presentation of key data, when rapid decisions are needed at critical parts of an operation or in an emergency.
• Acts as a prompt for best practice and safe care.

Scope

This scope of this report is limited to the anaesthetic record and the use of charts for adults in the operating theatre setting. Scope of this phase is restricted to: 

• The development of the Discovery Phase Report.
• The draft Information Standard.

Outcomes

The following recommendations have been made:

• The NHS should commission the development of the Anaesthetic Chart Standard as a good first step but should consider commissioning the development of integrated information standards for the complete perioperative pathway. This will future-proof standards developed and deliver maximum benefit.
• The full standard development cycle for the Anaesthetic Chart Standard should be commissioned to include full consultation, endorsement, piloting, and implementation support, together with the development of technical messaging standards.
• Implementation support should include, where possible, definition of benefits which can be attributed to implementation of an electronic anaesthetic chart.
• Due to the critical importance of the user interface design in the intraoperative operating theatre environment, detailed implementation guidance should be developed to cover this aspect. This should be led by clinicians to determine what good looks like, what mandatory information must be available and how this should be presented.
• Simulation can be utilised to identify pathway touchpoints (where data is created, used, or changed) and prototype requirements. User interface design should be specifically addressed in the Safety Case and with system suppliers.
• Conformance with the Anaesthetic Chart Standard should be mandated in the procurement process for Electronic Health Record (HER) systems.