The theatre team should all engage in the use of the World Health Organization surgical safety process42 commencing with a team brief, and concluding the list with a team debrief. The debrief should highlight things done well and also identify areas requiring improvement. Teams should consider including the declaration of emergency call procedures specific to the location as...
The supervising anaesthetist should not be responsible for more than two anaesthetised patients simultaneously, where one involves supervision of an AA.118
There should be sufficient numbers of clinical programmed activities in clinicians’ job plans to provide cover for all elective thoracic operating lists and to provide adequate emergency cover.45
Service developments outside the operating theatre often place unintended demands on anaesthetists. The business plans for such services should include provision for anaesthetic services.
Most research in thoracic anaesthesia will be undertaken in specialist cardiothoracic units and should be given high priority.
Regular clinical audit of the work of thoracic anaesthesia services is essential. This might also include submission of data to national audits, such as the ACTACC national audit project, which includes thoracic anaesthesia topics. Information technology support should be available for such activities.46,47
All thoracic units should have regular morbidity and mortality meetings. These meetings should be provided with a list of patients to discuss in advance, an attendance register, and minutes with learning points. Consultants or autonomously practising anaesthetists should attend these meetings and they should be included in job plans. Trainees should be encouraged to attend during their attachments.
Robust procedures should be in place to report and investigate adverse incidents involving equipment, staff or patients. The published outcomes of these investigations should be disseminated to all relevant anaesthetists and others.
