Skip to Main Content

++

  • Image not available. In the 1980s, anesthesiologists were recognized for being the first medical specialty to adopt mandatory safety-related clinical practice guidelines. Adoption of these guidelines, describing standards for basic monitoring during general anesthesia, was associated with a reduction in the number of patients suffering brain damage or death secondary to ventilation mishaps during general anesthesia.
  • Image not available. In 1999 the Institute of Medicine of the (U.S.) National Academy of Sciences summarized available safety information in its report, To Err is Human: Building a Safer Healthcare System, which highlighted many opportunities for improved quality and safety.
  • Image not available. It has long been recognized that quality and safety are closely related to consistency and reduction in practice variation.
  • Image not available. There is a natural tendency to assume that errors can be prevented by better education or better management of individual workers (ie, to look at errors as individual failures made by individual workers rather than as failures of a system or a process). To reduce errors one changes the system or process to reduce unwanted variation so that random errors are less likely.

++

As a profession, anesthesiology has spearheaded efforts to improve patient safety. Some of the first studies to evaluate safety of care focused on provision and sequelae of anesthesia. When spinal anesthesia was virtually abandoned in the United Kingdom (after two patients developed paraplegia following administration of spinal anesthetics), Drs Robert Dripps and Leroy Vandam helped prevent this technique from being abandoned in North America by carefully reporting outcomes of 10,098 patients who received spinal anesthesia. They determined that only one patient (who proved to have a previously undiagnosed spinal meningioma) developed severe, long-term neurological sequelae.

++

After halothane was introduced into clinical practice in 1954, concerns arose about whether it might be associated with an increased risk of hepatic injury. The National Halothane Study, perhaps the first clinical outcomes study to be performed (long before the term outcomes research gained widespread use), demonstrated the remarkable safety of the then relatively new agent compared with the alternatives. It failed, however, to settle the question of whether “halothane hepatitis” actually existed.

++

Image not available. In the 1980s, anesthesiologists were recognized for being the first medical specialists to adopt mandatory safety-related clinical practice guidelines. Adoption of these guidelines was not without controversy, given that for the first time the American Society of Anesthesiologists (ASA) was “dictating” how physicians could practice. The effort resulted in standards for basic monitoring during general anesthesia that included detection of carbon dioxide in exhaled gas. Adoption of these standards was associated with a reduction in the number of patients suffering brain damage or death secondary to ventilation mishaps during general anesthesia. A fortunate associated result was that the cost of medical liability insurance coverage also declined.

++

In 1984, Ellison Pierce, president of the ASA, created its Patient Safety and Risk Management Committee. The Anesthesia Patient Safety Foundation (APSF), which celebrated its 25th anniversary in 2011, was also Dr Pierce’s creation. The APSF continues ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessAnesthesiology Full Site: One-Year Subscription

Connect to the full suite of AccessAnesthesiology content and resources including procedural videos, interactive self-assessment, real-life cases, 20+ textbooks, and more

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessAnesthesiology

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.