BMJ 2000;320:785-788 ( 18 March )

Education and debate

Anaesthesiology as a model for patient safety in health care

David M Gaba, director. 

Patient Safety Center of Inquiry, 112PSCI, VA Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA

gaba@stanford.edu

The first 150 words of the full text of this article appear below.

Although anaesthesiologists make up only about 5% of physicians in the United States, anaesthesiology is acknowledged as the leading medical specialty in addressing issues of patient safety.¹ Why is this so?

Firstly, as anaesthesia care became more complex and technological and expanded to include intensive care it attracted a higher calibre of staff. Clinicians working in anaesthesiology tend to be risk averse and interested in patient safety because anaesthesia can be dangerous but has no therapeutic benefit of its own. Anaesthesiology also attracted individuals with backgrounds in engineering to work either as clinicians or biomedical engineers involved in operating room activities. They and others found models for safety in anaesthesia in other hazardous technological pursuits, including aviation. ^{2 3}

Secondly, in the 1970s and '80s the cost of malpractice insurance for anaesthesiologists in the United States soared and was at risk of becoming unavailable. The malpractice crisis galvanised the profession at all . . . [Full text of this article]

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