BC Airways Registry

Project Overview

Intubation is a high-risk and life-saving procedure that has been shown to have an increased rate of complications, such as failed intubation, hypoxia, hypotension, and surgical airway, when it takes place in the Emergency Department (ED), intensive care unit (ICU), and ward in comparison with the operating room (OR). Human factors and inadequate preparation are the most prevalent causes of medical error. 

The BC Airway Registry collects standardized data points during emergency intubation when respiratory therapists (RTs) are present. RTs complete standardized tick-box and text fields for specific intubation manoeuvers, post intubation attempts and complications for each intubation using an Airway form in Cerner and Meditech Expanse EMRs. These data points would not otherwise be captured consistently or in detail in the patient record. The details of the intubation and performance are then published as a PDF in the patient’s Documentation section, for communication between healthcare providers and to inform clinical decisions during future intubations. Additionally, we hope that the airway registry will lay the groundwork for future quality improvement interventions such as Difficult Intubation alerts and to identify common pitfalls during intubation that can be improved upon through education and standardization across health authorities. Data in the airway registry will allow us to track intubation performance on a monthly basis and provide the ability to compare intubation performance and compilation rates to other institutions and countries.

Data export from Cerner became semi-automated in 2024 at VCH and PHC, by exporting data from Cerner and importing them via CSV files into the BC Airway Registry stored in UBC Faculty of Medicine (FoM) REDCap (https://rc.med.ubc.ca). 

“The collaborative efforts of Kenny Hammond and the UBC Data Management team have significantly enhanced the BC Airway Registry. This initiative transitioned the registry from a paper-based system encompassing only three hospitals to a semi-automated data transfer process from Electronic Medical Records (EMRs), including Cerner (with future integration planned for Meditech Expanse), to UBC’s REDCap. As of October 1, 2024, the registry contained a substantial 16,737 unique patient intubation records across nine hospitals within three British Columbian health authorities. This expansion was facilitated by the UBC Data Management team’s effective collaboration with informatics teams across the various health authorities to establish a data pipeline for seamless data transfer from Cerner to REDCap. The Data Management team’s responsiveness and ease of collaboration have been instrumental in the successful expansion of this project to additional health authorities province-wide.”

-Dr. Jeff Yoo