Articles: professional-practice.
-
A questionnaire inquiring about existing and desirable work and rest patterns appeared in a newsletter mailed to about 22,000 anesthesiologists and anesthesiology residents and 24,000 nurse anesthetists (CRNA). Almost 3,000 anonymous replies were received and analyzed. Respondents reported mean work weeks of 47.5 h (CRNA) to 69.8 h (residents), longest continuous period of administering anesthesia without a break of 6.6 h (CRNA) to 7.7 h (residents), and longest period of administering anesthesia with or without breaks of 14.1 h (CRNA) to 20 h (resident). ⋯ The majority of respondents recalled having made errors in the administration of anesthesia that they attributed to fatigue. These results may not be representative of work patterns or attitudes among American anesthesia providers because of the small sample size and the resultant potential for bias. Yet, the subject deserves attention and further study because fatigue can affect professional performance, ability to learn, and family life.
-
The development of clinically based written standards to reduce the frequency and severity of medical malpractice loss appears to be gaining in popularity among provider specialty groups and professional liability underwriters. To date, such standards have addressed problems in specialties such as obstetrics and anesthesia where dollar losses associated with malpractice claims have been high. Guidelines can be developed and used by providers on a purely voluntary basis or mandated on an involuntary basis by third parties such as malpractice insurance companies or legislators. ⋯ Many providers are understandably concerned about the potential use of written standards by plaintiff attorneys in medical malpractice suits. Although it is possible that such policies and guidelines could be admitted into evidence to show that a provider breached the legal duty or standard of care owed to a patient, it is uncertain whether these risk-control standards could ultimately pass the evidentiary rules of relevancy or materiality in a given lawsuit. It is clear, however, that the consensus-based process of creating clinical standards and guidelines specifically for controlling professional liability losses is itself a powerful and emerging standard for health care risk management programs.