Journal of clinical anesthesia
-
The objective of the study was to: a) characterize the frequency, type, and outcome of anesthetic medication errors spanning an 8.5-year period, b) describe the targeted error reduction strategies and c) measure the effects, if any, of a focused, continuous, multifaceted Medication Safety Program. ⋯ Although medication errors persisted, there was a statistically significant reduction in errors during the study period. Formalized Medication Safety Programs should be adopted by other departments and institutions; these Programs could help prevent medication errors and decrease their overall incidence.
-
Observational Study
Interchangeability of counts of cases and hours of cases for quantifying a hospital's change in workload among four-week periods of 1 year.
Recent studies have made longitudinal assessments of case counts using State (e.g., United States) and Provincial (e.g., Canada) databases. Such databases rarely include either operating room (OR) or anesthesia times and, even when duration data are available, there are major statistical limitations to their use. We evaluated how to forecast short-term changes in OR caseload and workload (hours) and how to decide whether changes are outliers (e.g., significant, abrupt decline in anesthetics). ⋯ For purposes of time series analysis of total workload at a hospital within 1-year, hours of cases and counts of cases are interchangeable. Simple control chart methods of detecting sudden changes in workload or caseload, based simply on the sample mean and standard deviation from the preceding year, are appropriate.
-
The US Agency for Healthcare Research and Quality's State Ambulatory Surgery Database includes procedures performed at hospital outpatient surgery departments. We hypothesized that, among US hospitals with an anesthesia department and freestanding outpatient surgical center, the prevalence on hospital campuses (i.e., within 250 yards of the main hospital building) would be sufficiently large (e.g., >10%) to influence interpretation of observational studies performed with US national ambulatory surgery datasets. ⋯ The percentage of freestanding surgery centers located within 250 yards of main hospital buildings is sufficiently large to influence analyses. When using US national data, ambulatory surgery reported as performed at a hospital should not be considered as having been performed within the hospital. Similarly, hospital affiliated freestanding surgery centers should not be assumed to be more than a 5 min walk for anesthesia and operating room personnel from the hospital.