An electronic surgical order, undertaking patient education, and obtaining informed consent for regional analgesia before the day of surgery reduce block-related delays

Figures & data

Figure 1 P-chart of the proportion of all surgical case delays that were attributed to the RAPS performing a preoperative nerve block for all orthopedic surgical cases.

Note: P-bar = mean proportion.
Abbreviations: LCL, lower control limit; RAPS, regional anesthesia pain service; UCL, upper control limit.

Table 1 Demographic and clinical characteristics of study subjects

Variable	Pre-intervention group (N=388)	Post-intervention group (N=425)	P-value
Age, mean ± SD	55.7±15.3	57.2±14.9	0.154
Sex, N (%)			0.781
Female	230 (59)	256 (60)
Male	158 (41)	169 (40)
Race, N (%)			0.488
African American	81 (21)	99 (23)
Caucasian	301 (77)	315 (74)
Hispanic	5 (1)	5 (1)
Other	1 (<1)	6 (2)
Surgical procedures,			0.775
N (%)
Upper extremity	132 (34)	149 (35)
procedure vs lower extremity procedure	256 (66)	276 (65)
Type of block, N (%)			0.941
Single dose	146 (38)	161 (38)
Continuous catheter	242 (62)	264 (62)
Ultrasound guidance	145 (37)	127 (30)	0.024

Table 2 Regional nerve block-related primary process outcomes for three high-volume surgeons

Variable	Post-intervention group	Pre-intervention group	P-value
Patients eligible for a block, N	576	550
Eligible patients who received a block, N (%)	388 (67.4)	425 (77.3)	<0.001
Block patients with surgical case delay, N (%)	103 (26.6)	50 (11.8)	<0.001

Table 3 Univariate and multivariate regression OR for surgical case delay

Variable	Crude OR (95% CI)	P-value	aOR (95% CI)	P-value
Post-intervention group vs pre-intervention group	0.37 (0.26–0.54)	<0.001	0.36 (0.25–0.52)	<0.001
Single-dose block vs continuous catheter	0.52 (0.35–0.77)	0.001	0.53 (0.35–0.80)	0.002
Ultrasound guidance (yes vs no)	0.80 (0.54–1.17)	0.240	0.83 (0.56–1.25)	0.371
Location of nerve block (lower vs upper extremity)	1.09 (0.75–1.58)	0.652	1.05 (0.71–1.54)	0.806

Abbreviations: aOR, adjusted odds ratio; OR, odds ratio.