ANESTHESIOLOGY, January 2014 CME
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Hamilton acute pain service safety study—using root cause analysis to reduce the incidence of adverse events by Paul JE, Buckley N, McLean R, et al.
Summary: Although intravenous patient-controlled opioid analgesia and epidural analgesia offer improved analgesia for postoperative acute pain relief, they can also expose patients to risk of serious morbidity and, in some cases, mortality. Root cause analysis, a process for identifying the causal factors that underlie an adverse event, has the potential to identify and address system issues, thereby decreasing the chance for recurrence of these complications. This month’s Journal CME article compares data from more than 35,000 postoperative patients before and after a root cause analysis–led intervention. The intervention showed a one-third reduction in major adverse events, accompanied by a one-third increase in the incidence of severe pain.
The focus of ANESTHESIOLOGY Journal CME is to educate readers on current developments in the science and clinical practice of anesthesiology.
After completing this activity, the learner will be able to:
• Recognize adverse events in acute pain management that require root cause analysis (RCA)
• Apply RCA methodology to clinical adverse events
• Apply systems interventions to similar situations in acute pain management
Faculty & Credentials:
Editor-in-Chief: James C. Eisenach, M.D., receives consulting fees from Adynxx, NeuroGesX, and Vertex.
CME Editors: Leslie C. Jameson, M.D., receives honoraria from Masimo and honoraria from GE Medical International. Dan J. Kopacz, M.D., has ownership in Solo-Dex LLC.
Authors: Norman Buckley, M.D., F.R.C.P.C., Richard McLean, M.D., F.R.C.P.C., Karen Antoni, R.N.(E.C.), M.H.Sc., A.C.N.P., David Musson, M.D., Ph.D., Marianne Kampf, R.N., B.A., Diane Buckley, B.Sc.N., Michelle Marcoux, R.N., Rosemary Frketich, B.Sc.N., Lehana Thabane, Ph.D., and Ji Cheng, M.Sc., have reported no financial relationships with commercial interests. James E. Paul, M.D., M.Sc., F.R.C.P.C., has ownership in Adjuvant Informatics Inc.
ASA Staff: Employees involved in planning have no financial relationships with commercial interests.
Resolutions of Conflicts of Interest
In accordance with the ACCME Standards for Commercial Support of CME, the American Society of Anesthesiologists will implement mechanisms, prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity.
The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.
CME Credit:1.00 AMA PRA Category 1 Credit™
The American Society of Anesthesiologists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American Society of Anesthesiologists designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.1.00 Non-physician Credit
Non-physicians may receive a Certificate of Completion stating that this activity was designated for 1.00 AMA PRA Category 1 Credit(s)™.
ANESTHESIOLOGY's Journal CME is open to all readers. To take part in ANESTHESIOLOGY Journal-based CME, complete the following steps:
(1) Read the CME information presented on this page;
(2) Read this month’s article designated for CME credit in either the print or online edition;
(3) Register; nonmembers will be prompted to provide payment;
(4) Achieve a score of at least 50% correct on the six-question online journal CME quiz and complete the evaluation;
(5) Claim credit in 15-minute increments, for a maximum of 1 AMA PRA Category 1 Credit™ per journal article.
Required Hardware / Software:
Adobe Acrobat Reader
Internet connection, web browser version must have been released within the last three years.