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Optimising the use of IOFM technology

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Optimising the use of IOFM Technology


  • For patients undergoing high risk surgery, fluid status can have a major influence on post-operative outcome. There is good evidence now linking both hypovolemia and hypervolemia with peri-operative and post-operative complications and extended hospital stay
  • IOFM guided by an optimized cardiac stroke volume, has for many years been proposed as the “gold standard” for perioperative fluid optimisation, having been demonstrated and has been shown to reduce perioperative and postoperative complications and shorten length of hospital stay. A number of IOFM technologies are now available to support clinicians in more accurately optimizing patients’ fluid status
  • Without the use of IOFM technology, the volume of fluid administered to a patient depends to a large extent on the individual clinician, with large interprovider and intraprovider variability. This potential variation makes quality improvement activity extremely difficult and could mean that some patients will be put at risk unnecessarily
  • This Clinical Innovation Adoption project looks to promote the adoption of IOFM technology in clinical scenarios where there is good evidence of benefit.

Phase 1 Project Overview


To better understand the views and experiences of IOFM of anaesthetists
To understand the barriers to adoption from the perspective of key stakeholders
To design and develop tools that providers and commissioners can use to support use of IOFM moving forward


Project used qualitative and quantitative research methods
Clinical and non-clinical questionnaires
High level data submission from trusts around usage
Organisational audit of equipment, protocols and practices


The project engaged four stakeholder groups:
Clinicians (users)
Trust Management


Project Commenced in September 2014
Data collection started in December and Lasted 3 months
Findings were presented in April 2015

Outcomes & Recommendations

Full Phase 1 Report

Phase 2 Project Overview

Phase 2 of the project started in Jan 2016 and aims to focus on optimising the use of IOFM at engaged trust
The second phase plan has both local and regional elements and is structured as shown in the diagram below.
Local project teams at each of the engaged trusts has already started making arrangements for data collection

Related Content


Clinical Champion: Emmanuel Umerah, Deputy Medical Director, Frimley Health Foundation Trust
Project Manager: James Rose, Innovation Adoption Manager, Oxford AHSN

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