Pharmaceutical care of postoperative nausea and vomiting: Balanced scorecard for outcomes

J. F. Graumlich, S. M. Belknap, S. A. Bullard, G. A. Storm, K. S. Brunsman, J. A. Howerton

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Using the balanced scorecard to measure outcomes, a multidisciplinary team worked to improve antiemetic therapy and decrease postoperative nausea and vomiting. Patient satisfaction measures were nausea and pain scales (10 cm, nonnumbered, visual analog). The quality measure was number of vomiting episodes. Cost measures were length of postoperative stay and antiemetic requirement. Institutional learning was assessed by spread of prescribing changes beyond the first cohort of patients. Intervention subjects were providers of general anesthesia in two cohorts of patients (60 and 346) undergoing laparoscopic cholecystectomy. Outcome assessment revealed low nausea and vomiting scores throughout the study, and antiemetic use decreased 50%. There were no deteriorations in pain scores or length of stay. Balanced scorecard measurements suggest no adverse unintended outcomes consequent to changes in prescribing behavior. Balanced scorecard processes assisted consensus among pharmacists, nurses, and physicians that may have accelerated behavioral changes.

Original languageEnglish (US)
Pages (from-to)1365-1374
Number of pages10
Issue number11
StatePublished - 2000

ASJC Scopus subject areas

  • Pharmacology (medical)


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