Features  |   October 2017
Which Performance Measures Perform Best for Anesthesiologists?
Author Affiliations
  • Richard P. Dutton, M.D., M.B.A.
    Committee on Performance and Outcomes Measurement
  • David P. Martin, M.D., Ph.D., FASA
    Committee on Performance and Outcomes Measurement
Article Information
Quality Improvement / Features
Features   |   October 2017
Which Performance Measures Perform Best for Anesthesiologists?
ASA Monitor 10 2017, Vol.81, 12-15.
ASA Monitor 10 2017, Vol.81, 12-15.
Lifelong learning is a cornerstone of professionalism. As physicians, we wish to adopt new procedures and techniques to continuously improve patient care. Over the past decades, physician anesthesiologists have led research and education initiatives that have reduced serious adverse outcomes to approximately 250 per million anesthetics. Consequently, we are the acknowledged leaders in promoting patient safety and positive outcomes. While we can and should learn from individual adverse events, we should also learn from patterns in daily performance – the aggregation of all that we do. This kind of learning requires measurement.
One example of the power of accumulated events was our understanding of the catastrophic adverse event of blindness after general anesthesia. In the 1990s, most large practices had experienced a single case in recent memory – usually chalked off to unusual patient disease or bad luck. It wasn’t until the end of the decade when enough cases were aggregated that it became clear that this was a recurring complication. Recognition led to research, both basic science and clinical, to understand the mechanisms of posterior ischemic optic neuropathy and the ways in which this complication might be prevented. More mundane examples of the need for measurement are seen in the common issues of postoperative pain and perioperative nausea and vomiting; without aggregated data it is difficult for a practice to know if it is managing these issues well compared to others or improving over time.
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