Summary of "Anesthesia Patient Safety: Next Steps to Improve Worldwide Perioperative Safety by 2030"

Anesthesia Patient Safety Foundation past President Mark Warner, MD, assembled a comprehensive panel of 15 distinguished senior patient safety activists from 13 diverse countries around the world to present a thoughtful review of the current and future states of anesthesia patient safety in a 100^th anniversary issue of Anesthesia and Analgesia. Dramatic improvements in safety over past decades, particularly in highly resourced countries, are noted. However, there is widely variable progress in resource-challenged areas. Authors representing countries from all regions highlight their perspectives, including on Columbia, Honduras, India, Japan, Lebanon, New Zealand, Nigeria, Norway, Pacific Islands, Pakistan, Russia, Spain, and the United States. A key fundamental factor revealed is the availability of resources (financial, technical, facility, medications, and staffing, including of anesthesia professionals – a consistent critical point). Other central issues are population characteristics; healthcare system organization and functionality; adherence to standards (especially for monitoring); societal inequities; communication among co-workers; perioperative coordination, especially post-op; dramatic expansion of care outside traditional operating rooms; record keeping; quality statistics and reporting; and efforts to develop a “culture of safety.” Anesthesia safety education, training, and research vary significantly across the spectrum of countries. Importantly, an issue persists regarding individual blame for adverse events as opposed to a system and human factor analysis approach. A synthesis of the presentations shows a surprising commonality of concerns within the “huge variation” among countries and yielded a “top ten” list of anesthesia patient safety issues worldwide. Extensive summation commentary on attempting to address these issues does note limitations but provides a hopeful “roadmap” for further improvement in anesthesia patient safety.