In 2018 the APSF Board of Directors (BOD) voted on its top perioperative patient safety priorities. This list was generated from a combination of a review of the most current literature, submissions to the APSF Newsletter, and expert opinions from the multiprofessional representatives of the BOD. Since then, the APSF has devoted its resources to enhancing education, research, and awareness with regards to these priorities (https://www.apsf.org/article/improving-perioperative-patient-safety-a-matter-of-priorities-collaboration-and-advocacy/). The current BOD has felt the need to revisit the top patient safety priorities on an annual basis to accurately represent the most current perioperative patient safety issues.
Current APSF Vice President Dan Cole, MD, led a task force to generate a survey that was distributed to all APSF BOD and committee members. The poll responses were then tallied by the task force generated from the BOD. From a list of the top 16 priorities, the BOD voted on selection of the Top 10 Patient Safety Priorities for 2021 (figure 1). Past, present, and future activities focusing on these patient safety priorities are also listed in figure 1. A culture of safety, inclusion, and diversity ranked number one, while teamwork, collegial communication, and multidisciplinary collaboration, and preventing, detecting, determining pathogenesis, and mitigating clinical deterioration in the perioperative period were ranked two and three, respectively.
Figure 1: APSF’s 2021 Perioperative Patient Safety Priorities and Ongoing Activities
The following list contains our top 10 priorities and notes the activities for each that we have done in the past 5 years.
The summary of activities is not exhaustive.
|1. Culture of safety, inclusion, and diversity
2. Teamwork, collegial communication, and multidisciplinary collaboration
3. Preventing, detecting, determining pathogenesis, and mitigating clinical deterioration in the perioperative period
4. Safety in non-operating room locations such as endoscopy, cardiac catheterization, and interventional radiology suites
5. Perioperative delirium, cognitive dysfunction, and brain health
6. Prevention and mitigation of opioid-related harm in surgical patients
7. Medication safety
8. Emerging infectious diseases (including but not limited to COVID-19), including patient management, guideline development, equipment modification, and determination of operative risk
9. Clinician safety: Occupational health and wellness
10. Airway management difficulties, skills, and equipment
New additions to the current patient safety priority list include (2) teamwork, collegial communication and multidisciplinary communication; (6) prevention, and mitigation of opioid-related harm in surgical patients; (8) emerging infectious diseases (including, but not limited to COVID-19), including patient management, guideline development, equipment modification, and determination of operative risk; and (9) clinician safety, occupational health, and wellness.
The priority of creating a culture of safety was elevated to the top priority in 2021 and was modified to encompass the importance of inclusion and diversity in perioperative patient safety. All of these topics represent the current world we live in with respect to perioperative patient safety and are in line with the APSF’s vision “that no one shall be harmed by anesthesia care.”
Some topics that were ranked at the lower end of our priority list in 2018 did not remain on the top 10 priority list in 2021: (9) cost-effective protocols and monitoring that have a positive impact on safety; (10) integration of safety into process implementation and continuous improvement; (11) burnout; and (12) distractions in procedural areas. Some of these topics will be integrated into the new 2021 patient safety priorities and others did not gain traction for ranking when compared to the current ones.
The APSF is creating advisory groups whose goals are to develop recommendations on how to best allocate APSF resources to the 2021 Top 10 Patient Safety Priorities. These groups will also act as experts on the specific priorities so that the APSF can provide the most novel approaches to improving patient safety on these important issues to its worldwide constituency. Please join the APSF in making the necessary changes in your own practices as it relates to patient safety priorities and beyond.
Steven Greenberg, MD, is secretary of the APSF and editor of the APSF Newsletter. He is also clinical professor in the Department of Anesthesia and Critical Care at the University of Chicago and vice chairperson, Education in the Department of Anesthesiology, Critical Care and Pain Medicine at NorthShore University HealthSystem.
The author has no conflicts of interest.