Standardized Anesthesia InductioN Tool (SAINT) - the development and international adoption of an integrated electronic tool for documenting the induction of anesthesia in children.

The induction of anesthesia in children poses a challenge for the anesthesiologist, the parent and child. This process is multi-faceted and includes separation from parents, arrival in the operating room and the induction of anesthesia. Accurate and complete documentation of anxiety and negative behaviours and strategies that effectively mitigate these may assist during patient encounters. We aimed to develop a comprehensive electronic tool to capture and report behaviours during induction of anesthesia. After performing a literature search on existing validated tools for documenting behaviours during anesthesia induction, we used the nominal group technique to achieve agreement on the components to include in an integrated tool. We used Agile software development techniques to design and review the integrated electronic tool. Clinicians and informaticists from twelve international hospitals developed the integrated novel tool: the Standardized Anesthesia InductioN Tool (SAINT). SAINT incorporates validated scales for documenting key stages of the anesthesia induction journey (separation from caregivers, mask acceptance, induction behaviour, parental presence, the use of adjuncts and their effectiveness). In addition, the standardised data elements used in SAINT allow for local reporting, quality metrics and can assist in data across multi-centre trials. To date, the freely available tool has been adopted by 133 institutions across four countries. We show that collaborative development and rapid adoption of the comprehensive induction tool SAINT has led to its rapid adoption in the routine practice of pediatric anesthesiology across several countries. Further studies on how SAINT is being used for quality improvement or research are warranted.