Quality indicators for anesthesia For the past several years, physicians have participated in the Physician Quality Reporting System (PQRS) established by Medicare as a way to assess the quality of patient care and tie that to reimbursement. Beginning in 2015, a negative payment adjustment hit individuals and group practices whose…
The anesthesia quality improvement program at Vanderbilt University Medical Center in Nashville can claim a variety of successes, notably less postoperative hypo- and hyper-glycemia and fewer wound infections. When anesthesia providers noticed they weren’t monitoring blood glucose in patients with diabetes as frequently as their own goals specified, they put…
Editor's Note A few calming words from an anesthesiologist are as effective as medication in relaxing patients before anesthesia and surgery, finds research presented at the Anesthesiology 2015 annual meeting. Researchers compared conversational hypnosis (ie, talking quietly and positively and focusing the patient’s attention on something other than the upcoming…
Editor's Note The amount of propofol required for general anesthesia varies widely among patients, and some may be able to receive a lower dose than usually administered, according to a study presented at the Anesthesiology 2015 annual meeting in San Diego. The amount of propofol required to produce unconsciousness was…
Editor's Note The American Society of Anesthesiologists (ASA) and Premier, Inc, will extend their national learning collaborative to improve inpatient and outpatient care for surgical patients for an additional 2 years. ASA chose Premier in 2014 to develop a learning collaborative to implement the Perioperative Surgical Home (PSH) model of…
Editor's Note When the anesthesiologist sheaths the laryngoscope immediately after endotracheal intubation, contamination of the IV hub, patient, and intraoperative environment is significantly reduced, this study finds. In a simulated study using ultraviolet light to detect contamination of seven sites on a patient, contamination was found on an average of…
Editor's Note An anesthesiology-based service can meet the challenge of providing efficient and high-level care for surgical patients with cardiovascular implantable electronic devices, including pacemakers and implantable cardioverter defibrillators (ICDs), this study finds. Such a service, however, requires specialized provider training and strong support from the electrophysiology/cardiology service, and will…
Editor's Note In this study, the use of a preinduction checklist significantly improved information exchange, knowledge of critical information, and perception of safety in anesthesia teams. A total of 105 teams using the checklist were compared with 100 control teams. The outcome scores for the checklist group vs the controls…
Editor's Note Nearly one-quarter of more than 600 wrong-site surgery events reported to the Pennsylvania Patient Safety Authority (PPSA) since 2004 have involved wrong-site anesthesia blocks. Based on these findings, PPSA has developed evidence-based practices for preventing wrong-site surgery and wrong-site anesthesia blocks that complement the Joint Commission’s Universal Protocol.…
Editor's Note When anesthesiologists supervise anesthesia residents and nurse anesthetists, the amount of clinical work (total weekly hours) they perform does not positively correlate with the quality of the supervision they provide, this study finds. The results suggest that anesthesiology department managers should be monitoring (and perhaps reporting) the quality…