Measuring Patient Safety: Methods for Anesthesia Care

Avoiding iatrogenic adverse outcomes and providing safe care to patients is a priority in modern healthcare systems. In anaesthesia, measuring patient safety has been a matter of attention since the beginning of the speciality. The number of studies looking at anesthesia-related mortality-morbidity, adverse events and critical incidents reporting is substantial. These traditional patient safety measurement methods have significant limitations. They are qualitative by nature and often lack specificity for patient safety issues. Alternative approaches such as automated adverse events measurement in electronic records and safety culture questionnaires have been developed to overcome traditional methods’ weaknesses. However these lack validity and specificity for anaesthetic practice. Clinical indicators offer promise as they are specifically designed to measure non quantifiable concepts such as patient safety. However, at this stage, the number of clinical indicators validated for safety measurement in anaesthesia is limited. Further developments are required before indicators can be used on a large scale to measure safety of anaesthetic practice. Despite inherent weaknesses of existing methods, figures show that there is a clear decrease in the number of major accidents and severe complications associated with anaesthesia. Nevertheless, although anaesthesia can claim successes in reducing the number of major adverse outcomes, anaesthesia-related morbidity still remains significant. Poor teamwork and organisational failures play an important role into these complications. Improving communication and team coordination are the new challenges anaesthesia is facing. However to address these issues, being able to reliably measure patient safety in anaesthesia remains a priority