The anaesthetic department should engage with national safety initiatives such as ‘Stop Before You Block’ and audit practice, and should measure effectiveness against these initiatives.100
Decision support systems for crisis scenarios should be available, for example the Association of Anaesthetists Quick Reference Handbook.101
The anaesthetic department should develop and document a quality improvement (QI) plan in accordance with operational aims and objectives and in consultation with staff members. The QI plan should include all potential areas for improvement and adoption of innovation.43
The anaesthetic department should have a comprehensive and collaborative programme of engagement with QI initiatives locally, including audit of local guidelines and SOPs and improvements made following learning from incidents or near misses.102
The anaesthetic department should have a comprehensive and collaborative programme of engagement with QI initiatives at national level,103 for example ACSA, the RCoA Raising the standards : QI Compendium,43 national audit projects such as NELA, PQIP, SNAP and GIRFT. This should include embedding learning and improvement from these national initiatives.
The anaesthetic team should be provided with time and opportunity to engage with these QI projects.103
A departmental lead, with time identified for the role within their job plan, may help to provide oversight of these improvement projects within the totality of clinical governance activity of the department.
The department should use QI methodology to design, test and implement changes in care and monitor their impact using continuous live data to provide sustained improvement, as well as, where appropriate, engaging in a more formal cycle of assessment against defined standards, improvement and repeated further assessment.103
Specific, measurable, attainable, relevant and time bound (SMART) QI initiatives and safety measures should be embraced to improve patient and staff safety and wellbeing and to develop perioperative anaesthesia services.104
Anaesthetists should participate in departmental audit and should adhere to the standards and principles outlined in the RCoA ‘QI Compendium.43
