Features  |   October 2019
Putting Patients First: Treat the Patient, Not the Technology
Article Information
Education / CPD / Quality Improvement / Features
Features   |   October 2019
Putting Patients First: Treat the Patient, Not the Technology
ASA Monitor 10 2019, Vol.83, 16-18.
ASA Monitor 10 2019, Vol.83, 16-18.
If the specialty of anesthesiology is to be truly focused on “Putting Patients First,” there will need to be difficult and significant shifts in many of the current paradigms that underline what we currently view as metrics of our success. We can’t achieve this with false sincerity; the changes will be hard. The first and most obvious question is how much we currently value this concept as part of our clinical, operational and educational frameworks. Unfortunately, there seems to be significant evidence that we do not. A quick review in PubMed of the search terms “anesthesiology” and “efficiency” reveals hundreds of articles devoted to how anesthesiologists can improve operating room efficiency and throughput. In contrast, a review of the search terms such as “anesthesiology,” “patient engagement,” “shared decision-making” and “appropriateness” reveals very few. Patients are likely to be far more concerned about the latter areas than the former. Shared decision-making (SDM) is often associated with a decision aid for anesthesia type that, although important, is only one small part of establishing decisional quality. Also, this is not to imply that efficiency is not important, but to truly achieve health care value (quality/cost), the quality numerator needs to contain patient-centered metrics that go far beyond routine 30-day complication rates. Defining these metrics is currently a subject of intense investigation, as validated metrics of patient engagement and SDM will be essential for us to benchmark in these areas. They don’t currently exist.
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