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Table 1 Icons Used in the Patient Surveillance View

From: Use of a novel electronic maternal surveillance system to generate automated alerts on the labor and delivery unit

Condition Icon Description Data Source(s)
Airway Exam Missing This icon is displayed when an airway examination has not been documented. AIMSa
At Risk for Difficult Intubation This patient is at risk for difficult intubation. This is defined by the documentation of three or more of the following risk factors: Mallampati score III, body mass index > 30, limited jaw protrusion, history of obstructive sleep apnea, history of snoring, presence of a thick neck or radiation changes. AIMS
Known Difficult Intubation This patient had prior documented difficulty with intubation. This is defined by the documentation of one of the following: Mallampati score IV, difficult airway letter, fiberoptic intubation, video laryngoscope intubation, difficulty with mask ventilation, Cormack-Lehane direct laryngoscopy view of three or four. AIMS
Documentation Deficiency The patient’s chart contains a documentation deficiency. EHRb
Black Alert Always displayed in the lower right hand corner of a patient rectangle if conditions for a black alert are met. Bedside Monitor, EHR, Laboratory System, Blood Bank
Red Alert Always displayed in the lower right hand corner of a patient rectangle if conditions for a red alert are met. This icon will flash if conditions for a flashing red alert are met. Bedside Monitor, EHR, Laboratory System, Blood Bank
IV Size IV size currently in place. The number within the box indicates the documented gauge of the IV. EHR
Heart Disease Displayed if the patient has any documented cardiac disease. AIMS, EHR, Text Parserc
Refuses Blood Displayed if documentation is found indicating patient refusal of blood products. AIMS, EHR, Text Parser
Care Note Displayed if a multidisciplinary care note is found for this patient. If present, this care note is found in a consistent location within the patient EHR. EHR
Prior Cesarean Delivery or Uterine Surgery Displayed if there is a documented history of cesarean delivery or diagnosis code related to surgery involving the uterus. AIMS, EHR, Text Parser
Pre-eclampsia Displayed with documentation of pre-eclampsia without severe features. EHR, AIMS, Text Parser
Severe Pre-eclampsia Displayed with documentation of pre-eclampsia with severe features. This is also displayed if a magnesium infusion has been documented within the EHR medication administration record. EHR, AIMS, Text Parser
Multiple Gestation Displayed if patient has a multiple gestation pregnancy. EHR, AIMS, Text Parser
Epidural An epidural catheter is in place. The icon turns red if the patient’s pain score ≥ 5. The icon disappears after documentation of removal of the epidural catheter. AIMS, EHR
Abnormal Placentation Displayed with documentation of abnormal placentation, i.e. placenta previa, placenta accreta, placenta increta, or placenta percreta. AIMS, EHR, Text Parser
Risk of Postpartum Hemorrhage Displayed if patient is suspected to be at risk for postpartum hemorrhage. AIMS, EHR, Text Parser
Postpartum Hemorrhage Displayed if > 500 mL of blood loss is documented after vaginal delivery, or if > 1000 mL of blood loss is documented after cesarean section. AIMS, EHR
Spine/Anticoagulation Warning Displayed if an absolute or relative contraindication to neuraxial anesthesia is present. E.g. therapeutic anticoagulation. AIMS, EHR
Paging Limit Change Displayed if the automated paging thresholds for this patient have been modified. N/Ad
  1. aAIMS = Anesthesia Information Management System. The AIMS at our institution is an implementation of Centricity™ Perioperative Anesthesia (GE Healthcare, Chicago, IL). Unless otherwise specified, data are collected from discrete fields within the AIMS
  2. bEHR = Inpatient Electronic Health Record. MiChart, an implementation of the EPIC clinical information system (EPIC Systems Inc., Verona, WI), is used at our institution. Unless otherwise specified, data are collected from International Classification of Diseases (ICD-9 or ICD-10) codes contained within the patient problem list and from discrete fields within the EHR
  3. cText Parser = A text parser was created to detect comorbidities documented within non-discrete fields within the AIMS history and physical document and within free-text handoff documentation in the EHR
  4. dN/A = Not Applicable
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