In this issue, the first one of APSF’s Newsletter Volume 3, it seems reasonable to reflect upon the first two years of the Foundation and its future The mission remains the same to encourage activities that will prevent patients from being harmed by anesthesia care. The Foundation has been enthusiastically received in many quarters. Some, however, have criticized us for being excessively oriented toward equipment monitors and state-of-the-art anesthesia machines. The Foundation’s Executive Committee, indeed, encourages this criticism because it helps us to discover the directions we should be taking. Honest differences of opinions always exist among anesthesia clinicians.

Recently, I wrote the following to one of our supporters who had voiced concerns; “The APSF continues to have as its only goal the enhancement of safety in anesthesia. We have had to take this development one step at a time and are indeed still feeling our way. I believe that the first major approach was to try to cut the incidence of catastrophic events, especially those which have been undoubtedly reduced by use of oximetry and capnography. The Foundation has very strongly and studiously avoided anything approaching the setting of standards or demanding that certain equipment or machines be used. Rather, we have attempted to emphasize safety through education and awareness’ ” I believe, in fact, that the expenditure of Foundation funds so far has been primarily in areas not benefiting industry although industry has provided the major financial support thus far to the Foundation.

In my view, the two most important undertakings by the Foundation have been the Research Grant Program and the APSF Newsletter. Neither of these is equipment oriented. It is interesting to examine the front page lead headline in some of the newsletters published thus far: Leadership and Quality Care in Anesthetic Practice; FDA Issues Pre-use Check-out; Anesthesia Claims Decrease; ASA Adopts Basic Monitoring Standards; Support and Service Crucial to Safety; Better Labels Will Cut Drug Errors.

Efforts will continue to promote education in anesthesia patient safety as the prime focus of the Foundation. Hopefully, the attempts so far the research grants and newsletter noted above, the videotape and book on Capnography, the videotape and book on Safety and Cost Containment in Anesthesia, the videotape Spot the Error and the postponed Grand Anesthesia Safety Symposium will be seen as true educational undertakings.

This year the Foundation will bring together several investigators working on simulators and a number of anesthesia educators to explore the potential use of simulators in anesthesia education and training, especially in the management of the rare crisis situation. Strong efforts have been made to eliminate any commercialism in this workshop.

The Foundation is funding a survey to assess national and international work practices of anesthesiologists. A pilot study, already completed, is to be expanded into a larger survey, reviewing the role of fatigue and anesthesia patient safety.

Consideration of standards for anesthesia machines has been an agenda item for the ASA Committee on Patient Safety and Risk Management not the Anesthesia Patient Safety Foundation. The Foundation’s Committee on Education and Training, however, is planning a multi-disciplinary conference to prepare a set of educational materials for describing current safety features of the anesthesia machine and whether or not older machines can be modified to include individual safety devices.

In the last issue, APSF circulated a questionnaire seeking opinion of the readers concerning future safety symposium presentations. We encourage participation by all of you who read the Newsletter in helping the Executive Committee and Board to plan programs over the next two years. Examine us, criticize us, write to us. Let us work together toward the complete elimination of preventable anesthesia morbidity and mortality.

Ellison C. Pierce, Jr., M.D. President Anesthesia Patient Safety Foundation