Focusing on CQI

Meeting the anesthesia requirements of an increasing number of surgical as well as office-based procedures can sometimes compromise the quality of healthcare provided. Maintaining high standards means implementing a Continuous Quality Improvement (CQI) program to evaluate performance and identify areas in need of attention.

CQI for medical services, often referred to as managed care, is based on evaluation of a product or the outcome(s) of a process. It involves a clear understanding of the needs and expectations of the consumers of these products or processes.

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The greatest value of CQI is in identifying areas of change while planning improvements. A successful program depends on documentation, accountability and assessment. For anesthesia services this involves tracking complications and unexpected outcomes as well as anesthetist competency.

10 things an Anesthesia Services CQI program must include

1. A detailed clinical assessment of the facilities you are working with to ensure they are in compliance with approved standards of health care
2. Examining credentials of your anesthetists and CRNAs to minimize liabilities and implement best practices
3. Having a well-documented plan for benchmarking your anesthesia services and evaluating anesthetists (like peer reviews)
4. Implementing a proper anesthesia delivery process that conforms to required standards and minimizes error
5. Online technology to facilitate communication between anesthetists, the anesthesia consulting firm and medical centers they service. Should also have an online mechanism for dissemination of information and education for staff.
6. Regular reporting by anesthetists/CRNAs, patient satisfaction surveys, staff and/or client meetings to record and discuss cases (especially those with complications and unexpected outcomes)
7. Routine checks on equipment and anesthesia providers to ensure compliance and maintain quality
8. Assigning local staff  familiar with the medical center/office-based physician’s modus operandi to improve patient outcomes
9. Strategies for risk management as well as securing anesthetist and CRNA buy-in to change
10. Process to measure results and effectiveness

Share with us your CQI strategies for improving anesthesia services.

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Is there a difference between Sedation and Monitored Anesthesia Care (MAC)?

No matter what the procedure, every patient’s main concern is pain level, speed of recovery and quality of healthcare services. The debate over methods of sedation is an ongoing one. BUT, Monitored Anesthesia Care (MAC) has proven to be clinically safe, improve patient comfort and aid faster recovery.

The biggest difference between Sedation and MAC is continuous monitoring. With Sedation, anesthesia levels in a patient’s system are not as heavily monitored and it often becomes a guessing game. With MAC on the other hand, a dedicated resource is watching patient vitals and monitoring status throughout the procedure from pre to post-op. At any point, there is full knowledge of exactly how much of the anesthetic drug is in a patient’s system. This rules out the chances of less than a required dosage or an overdose on anesthesia.   

Key benefits of Monitored Anesthesia Care or MAC:

• Only a licensed anesthetist or CRNA assesses and manages the patient’s condition throughout the procedure.
• Continuous monitoring increases patient safety and comfort. MAC provides cost-effective pain relief.
• Even small doses of sedation medication can cause adverse physiological response. MAC requires a qualified CRNA or anesthetist who is trained to deal with any medical problems or complications that may arise during the procedure.
• The healthcare professional delivering MAC monitors the patient’s condition throughout the procedure and eliminates the need for additional medical staff during sedation or recovery.
• Improves efficiency, quality of medical procedures and number of patients a facility can serve. Hospitals, surgery/ambulatory centers and office-based physicians can better manage patient volumes by using MAC.

While disturbing to know, it’s a fact that in some medical centers propofol sedation is not administered or monitored by a qualified anesthesia provider. Outsourcing your anesthesia services to an established provider like Steel City Anesthesia LLC increases patient safety and reduces your liabilities — a win-win situation for your healthcare facility and the patient. MAC can mean the difference between safe, top quality healthcare and increased risks of complications or even death from overdose. Remember what happened to Michael Jackson?

Would you like to share your thoughts or observations about sedation vs. MAC? We’d love to hear from you on our blog.

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