As the Anesthesia Patient Safety Foundation launches its major new initiative concerning the role of information (gathering, management, systems, etc.) in patient safety, a note on context is appropriate. When the APSF was organized in 1985 by Ellison C. "Jeep" Pierce, Jr., MD heading a group of safety conscious representatives from the anesthesia practitioner community, industry, and regulatory and support organizations, it was with the recognition that anesthesia was not as safe as it should be. Ventilation problems were the main culprit at that time. APSF vigorously supported the introduction and adoption of pulse oximetry and capnography. Over 16 years have passed since and anesthesia is safer for patients now than ever before. However, we cannot rest on our laurels. The reports of the Institute of Medicine remind us that all too many patients suffer harm while receiving medical care, the very circumstance where their health and well-being should be protected better than in any other setting. To realize another full step of improvement in the quality of anesthesia care, we now need data that will enable us to pinpoint the problems responsible for preventable anesthetic morbidity and mortality.
Last fall, APSF took the first step on this quest for information by directing its focus on the collection and interpretation of perioperative data through organizing a conference on data management in anesthesia (see last Winter’s APSF Newsletter). Clearly, the handwritten intra-operative anesthesia record with its many omissions and inaccuracies will become a relic viewed with amusement by future generations of anesthesiologists. The transition from the past to the future in this arena, however, is arduous. With this issue of the Newsletter, APSF shines a light on the promise and problems of automated peri-anesthetic data management. We can take heart by reading about the accomplishments of the pioneers in this area and we can discern the outline of what the future will bring. This is an exciting time.
This collection of articles starts with an overview by Dr. Dan Thys of New York. In a report from Europe, Dr. Jeffrey Feldman and his colleagues provide a glimpse at the experience there. Dr. Chester Phillips discusses the preoperative evaluation, Dr. Sachin Kheterpal the intra-operative record and Dr. Michael O’Reilly the postoperative period. Questions that may arise when establishing an automated record-keeping system are identified and explored by Dr. William Schwab. A look at some of the things we don’t record—at least as yet—concludes this brief series on automated anesthesia data management systems.
APSF Task Force on Data Management in Anesthesia:
J.S. Gravenstein, MD, Dr.med. h.c., University of Florida
John P. Abenstein, MD, Mayo Clinic, Rochester
Neil Feinglass, MD, Mayo Clinic, Jacksonville
Jeffrey M. Feldman, MD, MS, Draeger Medical
Sachin Kheterpal, MD, GEMS IT
Keith Long, MD, Private Practice, Belmont, MA
Michael O’Reilly, MD, MS, University of Michigan
Chester A. Phillips III, MD, Agilent
David L. Reich, MD, Mt. Sinai School of Medicine
Daniel M. Thys, MD, Columbia University
Wilhelm K. Schwab, PhD, University of Florida