President Reports on State of APSF

Robert K. Stoelting, MD

As President of the Anesthesia Patient Safety foundation (APSF), it is my privilege to report annually on the activities of the APSF during the past calendar year. I am pleased to report that 2002 has been a productive and rewarding year for the APSF as we strive to fulfill our mission that every patient experience safe anesthetic and perioperative care.

Automated Information Systems

During 2002 the APSF continued to develop the 2001 initiative dealing with automated information systems. The APSF remains committed to the position that the use of automated record keeping in the perioperative period and the subsequent retrieval and analysis of these data to improve patient safety are important goals. To emphasize the continuing importance of information systems, the APSF sponsored a workshop at the annual meeting of the American Society of Anesthesiologists in October 2002 entitled “Advancing the Use of Information Systems to Improve Patient Safety.” The workshop was organized and moderated by Michael O’Reilly, MD, from the University of Michigan (See APSF Conference, Page 53.) Attendees included anesthesiologists and representatives from industry. In addition, the Summer 2001 issue of the APSF Newsletter was a special issue devoted to “Information Systems.”

High Reliability Perioperative Health Care

A future initiative of the APSF will be development of the concept of high reliability organizations (HRO) as applied to the operating rooms and other perioperative facilities. HRO describes a process which focuses on organizational structure to improve efficiency and safety. It is noteworthy that the HRO concept encompasses a number of activities that APSF finds relevant including electronic record keeping, simulation, reporting of adverse events and near misses, and neutral investigations of serious adverse events and errors. In this regard, the Executive Committee of the APSF has formed a Task Force on High Reliability Perioperative Health Care (HRPHC) chaired by David M. Gaba, MD. A future special issue of the APSF Newsletter will highlight details of this concept.

Data Dictionary Task Force

The Data Dictionary Task Force (DDTF) chaired by Terri G. Monk, MD, from the University of Florida has made substantial progress in its goal to develop a common dictionary of anesthesia terms (See DDTF Report, Page 63.) This process has been greatly enhanced by the efforts of Dr. Iain Sanderson from Duke University. Dr. Sanderson is an informatics expert who directs the DDTF Technical Working Group and is developing a mapping system so that data collected by different automated anesthesia record systems can be compared across data collection platforms using the APSF data dictionary as a common reference. Members of the Technical Working Group include Deio; Dräger Medical, Inc.; eko systems, inc.; GE Medical Systems; Picis, Inc.; Philips Medical Systems; and Siemens Medical Systems. These industry representatives, as well as the APSF, have provided financial support for the work of the DDTF.

Reorganization of the Executive Committee

In May 2002 the APSF Executive Committee recommended certain bylaws changes to the APSF Board of Directors. The most substantive recommended bylaws change included the reorganization of the Executive Committee to establish the Executive Vice President position. The person occupying this position will be expected to serve as an advisor to the President for the day-to-day activities of the Foundation. All other offices, including the office of Vice President, remain unchanged. The recommended bylaws changes were approved by the APSF Board of Directors at the annual October 2002 meeting of the Board.

Ellison C. Pierce, Jr., MD, Research Award

The capital campaign chaired by Drs. E.S. Siker and James F. Arens to establish the Ellison C. Pierce, Jr., MD, Research Award has been very successful. In recognition of excellence, a single funded grant will be provided with an unrestricted additional $5,000 grant above the requested amount as the Ellison C Pierce, Jr., MD, Research Award.

Newsletter

The APSF Newsletter under the leadership of its Editor, Robert C. Morell from Wake Forest University, continues to provide timely and world-wide distribution of critically important anesthesia patient safety information. During the past year the Newsletter has included articles on perioperative beta-blockade and associated morbidity and mortality, sleep apnea and postoperative pain management, use of amiodarone in new ACLS protocols, and issues surrounding the FDA warning on the use of droperidol. Dr. Azriel Perel described a “Point of Care Information System” that has been endorsed by the European Society of Anesthesiologists and can be included as part of operating room monitoring systems. In addition, the Spring 2002 issue of the APSF Newsletter was a special issue devoted to bioterrorism.

Continued Research Support

Sponsorship of anesthesia patient safety-related research has always been a high priority for APSF. In October 2002, the APSF Committee on Scientific Evaluation, chaired by Sorin Brull, MD, awarded two research grants with funding up to $65,000. One of these grants received an additional $5,000 as the Ellison C. Pierce, Jr., MD Research Award (see Grant Awards, page 60). An additional educational support grant during 2002 was awarded by the APSF to Sem Lampotang, PhD for development of instructional material for a computer generated virtual anesthesia machine. Dr. Lampotang’s work was available at the APSF booth during the October 2002 annual meeting and was very positively received. The APSF is also a co-investigator with the National Patient Safety Foundation in the development of web-based patient educational materials in a study funded by Agency for Healthcare Research and Quality (AHRQ).

Special Recognition

At the conclusion of the 2002 APSF Board of Directors meeting, Drs. E.S. Siker and Joachim (Nik) S. Gravenstein concluded their membership on the APSF Executive Committee and Board of Directors. Both of these highly respected anesthesiologists had been members of APSF since its formation in 1985. They were both recognized for their contributions to APSF at the annual APSF/FAER dinner in October 2002. Drs. Siker and Gravenstein have made invaluable and sustained contributions to anesthesia patient safety, and we all thank them for their years of participation in APSF. In addition Burton A. Dole, long-time member of the APSF Executive Committee and Vice President of APSF retired from the Executive Committee. Like Drs. Siker and Graventstein, Mr. Dole is a founding member of APSF and his contributions and coordination of support from members of industry have been invaluable to the anesthesia patient safety movement. We are all pleased that Burt will remain as a member of the Board of Directors.

Contributions from individuals, corporations, and national and state societies are critical for the APSF to continue and advance its patient safety mission. The generous financial support from our founding sponsor, the American Society of Anesthesiologists, is vital for the continued ability of the APSF to provide education, research, and information related to anesthesia patient safety to everyone. All donors and their level of support are recognized in the APSF Newsletter. In particular, the support of AstraZeneza in the form of a grant for defraying the costs of the APSF Newsletter is greatly appreciated. I believe that all can be proud of the results of their continued support of APSF.

As in the last annual report, I wish to again reiterate the desire of the APSF Executive Committee to provide a broad-based consensus on anesthesia patient safety issues. We welcome comments and suggestions from all those who participate in the common goal of making anesthesia a safe medical experience. There is still much to accomplish and everyone’s participation is important.

Best wishes for a prosperous and rewarding year 2003.

Robert K. Stoelting, MD
President
Anesthesia Patient Safety Foundation