ANESTHESIA - RISK MANAGEMENT ISSUES

Course overview

There have been numerous advances that have made the practice of anesthesia safer over the last 30 years. These include advances in technology, such as the pulse oximeter and the measurement of end-tidal CO2, as well as human factors, such as the standardization of many practices. Anesthesia has solved many of the issues that cause frequent claims, but claims against anesthesia providers still tend to be severe when they happen. It is important to remember that there is a system involved in administering anesthesia and that most errors are caused by faulty systems. Errors may never be totally eliminated, but they can be reduced. One of the best mechanisms for reducing errors is the root cause analysis. However, root cause analyses are only effective if they reach a system or process flaw. If the analysis stops at blaming someone for being careless or not paying attention, it has not achieved its objective. It must address the system or process issues that allowed someone to be inattentive. The ultimate goal, of course, is to practice in an error-free mode. In this activity, we discuss the importance of the pre-anesthesia evaluation, including the informed consent process covering both the risks and benefits, preserving evidence after a major adverse event, medication preparation issues, standard of care and failure to monitor responsibilities. After completing this activity, practitioners should be able to: demonstrate how documentation can be used to strengthen the defensibility of a case in the event of litigation; appraise the need to investigate an event fully before evidence is discarded; and interpret the standard of care and how it affects anesthesia practice.