Fellowship posts should be identified to allow additional training for those who wish to follow a career in cardiac anaesthesia(Including adult congenital heart disease and paediatric cardiac anaesthesia) to ensure that there are adequate numbers of skilled anaesthetists in the specialty. These should be suitable for trainees who wish to take time out of training programmes or for those who...
Departments should consider providing all newly appointed consultants or autonomously practising anaesthetists, particularly those with limited experience, with a mentor to facilitate their development in cardiac anaesthesia.
Anaesthetic involvement in the leadership of cardiac units should be considered.
There should be a joint forum for discussion of matters relevant to both surgeons and anaesthetists, for example protocol development and critical incidents.
Clinical protocols should be developed from national and international guidelines and reviewed and implemented on a regular basis. This may include, for example, guidance for coagulation management, venous thromboembolism treatment, and treatment for anaemia and patient blood management.
Hospitals should have systems in place to facilitate multidisciplinary meetings for discussion of high-risk and complex cardiac procedures to allow for adequate advance planning of service provision.
All handovers should contain representatives for the multidisciplinary teams from both theatre and the receiving area and should be documented and structured to ensure continuity of care.53
The theatre team should all engage in the use of the World Health Organization surgical safety checklist,54 commencing with a team brief and concluding the list with a team debrief. The debrief should highlight things done well and should also identify areas requiring improvement. Teams should consider including the declaration of emergency call procedures specific to the location...
Hospitals should review their local standards to ensure that they are harmonised with the relevant national safety standards, such as the National Safety Standards for Invasive Procedures in England or the Scottish Patient Safety Programme.55,56 Organisational leaders are ultimately responsible for implementing local safety standards as necessary.
