Past accomplishments and future directions: risk prevention in anesthesia and surgery.
Anesthesiology has served as a model for patient safety in health care and was the first medical profession to treat patient safety as an independent problem. Anesthesiology has implemented widely accepted guidelines on basic monitoring, conducted long-term analyses of closed malpractice claims, developed patient simulators as meaningful training tools, and addressed problems of human error. The National Surgical Quality Improvement Program is the first national, validated, and peer-controlled program that uses risk-adjusted outcomes for the comparative assessment and improvement of the quality of surgical care. The program has reduced postoperative complications in the Veterans Administration, at both national and local levels. It is becoming more evident that processes and events during surgery can be important determinants of long-term outcomes after anesthesia and surgery.
Stoelting
Robert K
RK
Anesthesia Patient Safety Foundation, 8007 South Meridian Street, Building One, Suite 2, Indianapolis, IN 46217, USA. rstoelting@aol.com
Khuri
Shukri F
SF
D000758:Anesthesia / Q000009:adverse effects / Q000592:standards* / Q000639:trends; D000761:Anesthesia Department, Hospital / Q000592:standards*; D006801:Humans; D008991:Monitoring, Physiologic / Q000592:standards; D009313:National Health Programs; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000379:methods*; D020379:Risk Adjustment; D017751:Safety Management / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000592:standards* / Q000639:trends; D014481:United States