PATIENT SAFETY: Handoffs between ICU and OR

There is a lot of literature describing problems with, and best practices for, the transfer of care of post-surgical patients moving into the intensive care unit setting.  However, after conducting a comprehensive literature search, the authors of this brief commentary found no comparable literature about the reverse type of handoff – for patients going from the special care unit into surgery.  They suggest that a checklist be adopted and give an example of one such checklist.  They also recommend that a verbal handoff be required.

What do I like about this article?  The authors are authoritative (Mount Sinai and Johns Hopkins medical schools) and I like the actual example of the handoff checklist.  Also, I like it that they appear to be filling a gap in the medical literature – at least at the time that they wrote this commentary.

Source: Evans, A.S., Yee, M.S., and Hogue, C.W. (2014, Mar.). Often overlooked problems with handoffs: From the intensive care unit to the operating room.  Anesthesia & Analgesia, 118(3), 687-689.  Click here for free full text: http://journals.lww.com/anesthesia-analgesia/Fulltext/2014/03000/Often_Overlooked_Problems_with_Handoffs___From_the.31.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

DRUG SHORTAGE: 8 anesthesia drugs most affected

There is a drug shortage in the US affecting anesthetic, anti-infective, and oncology drugs, among other drug classes.  The American Society of Anesthesiology conducted a survey to find out which anesthetic drugs are in short supply in 2012.  Just over 3000 anesthesiologists responded to the survey and almost all said that they have had to alter their drug preferences for certain procedures due to the shortage.

Top Anesthetic Drugs Reported in Short Supply (in order with the most frequently mentioned at the top)

• Fentanyl
• Thiopental
• Succinylcholine
• Propofol
• Midazolam
• Pancuronium
• Neostigmine
• Glycopyrrolate

Source:  Byrd, J.R., and Singh, L.  Breadth and depth of anesthesia drug shortages increasing: summary of ASA survey.  Newsletter [American Society of Anesthesiologists];76(6):56-75, June 2012.  Click here for more from the publisher: http://viewer.zmags.com/publication/d4a68879#/d4a68879/60 Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

ACOs: Should you include a ‘surgical home’?

The American Society of Anesthesiologists (ASA) has proposed a coordinated perioperative, or surgical home, model which would give anesthesiologists a leadership role in the development of an important component of accountable care organizations (ACOs).  This is a counterpart to the medical home model (which focuses on primary care and patients with chronic disease).  ASA envisions that anesthesiologists would evolve into “perioperative physicians” in this model.

Interesting fact: An estimated 60 to 70 percent of hospital expenses are related to patients who have surgery or undergo procedures.

Sources:  American Society of Anesthesiologists.  The Perioperative or Surgical Home, Aug. 21, 2011.  Click here for full text: http://www.saaahq.org/ThePerioperative_orSurgicalHome.pdf;  Warner, M.A.  The surgical home.  Newsletter. American Society of Anesthesiologists;76(5):30-32, May 2012; and, ASA responds to accountable care organization proposed rule.  Press Release, June 3, 2011.  Click here for full text: http://www.asahq.org/For-Members/Advocacy/Washington-Alerts/ASA-Responds-to-Accountable-Care-Organization-Proposed-Rule.aspx  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org