Title: Optimizing Anesthesia Controlled Substance Auditing through Control Check Implementation: A Performance Improvement Initiative Authors: Julianne Anderson, PharmD; Harshal Shukla, PharmD, BCPS, DPLA; Vicken Yaghdjian, PharmD Learning Objective: At the conclusion of this presentation, the participants will be able to identify how automated auditing technology can reduce controlled substance discrepancies and improve accountability in the perioperative anesthesia setting. Background/Objective: Controlled substances (CS) in the operating room are high risk for diversion and documentation errors. This performance improvement imitative aims to reduce the CS discrepancy rate by 50% from baseline within our perioperative anesthesia areas. Methods: This performance improvement, pre–post interventional study was conducted in the perioperative anesthesia departments at Montefiore Moses and Jack D. Weiler hospitals. Retrospective manual audit data were compared with prospective data following implementation of the Control Check auditing process to evaluate changes in controlled substance discrepancy rates and resolution timelines. Outcomes were monitored at baseline and throughout Plan‑Do‑Study‑Act (PDSA) cycles, including percent change in discrepancy rate, average time to discrepancy resolution, and percent of unresolved discrepancies at 30 days. Results: Baseline results show a 10.7% unreconciled rate at Jack D. Weiler Hospital (Weiler) and a 27.7% unreconciled rate at Moses Hospital. Of the reconciled discrepancies, the time to resolution were a median of 2 days (mean of 2.39 and 2.19 days at Weiler and Moses, respectively). At both campuses, resident physicians were the most likely to make a discrepancy and the reason for the discrepancy was that the administration was documented late. The results of the PDSA cycle are ongoing, but preliminary data suggests that adding a second mode of communication to providers yields a lower unresolved discrepancy rate and a shorter time to resolution. Conclusion: Implementation of an automated controlled substance auditing platform in the perioperative anesthesia setting improved oversight by standardizing discrepancy detection and accelerating resolution timelines. This performance improvement initiative demonstrates the potential for technology‑enabled auditing to enhance accountability, reduce risk of diversion, and support regulatory compliance while decreasing manual workload. Self-assessment Question: True/False: Automated auditing technology improves controlled substance accountability by enabling standardized, real‑time identification and follow‑up of discrepancies in the perioperative setting.
