In our Q4 audit across three sites, 12% of post-anesthesia evaluations missed provider sign-off within the 48-hour window, which keeps us out of alignment with CMS and Joint Commission requirements. If you’ve driven this metric past 95% without alert fatigue, what worked — an Epic BPA with a timed reminder, a daily compliance report to charge CRNAs, or another sustained PDSA approach?
We hit 97% with an Epic discharge BPA and 8 a.m… dashboard; allow PACU ‘snooze’ to prevent fatigue.
this ‘48-hour’ miss drives me nuts — we closed it by adding a hard-stop attestation at anesthesia sign-out in Epic plus a 36-hour In Basket ping to the responsible provider, which got us to about 97% without frying folks. Small catch: the hard stop won’t fire on incomplete cases, so we push a daily compliance list to service chiefs for gentle follow-up; @smitchell88 the snooze is nice, but the 36-hour timing mattered more for us.
It’s super frustrating when we miss those sign-offs… We had success with customized alerts in Epic that remind team members to complete the evaluations just before the deadline. Just a little nudge can make a big difference.