July 1, 2013
Volume 77, Number 7
What's New In... ASA Committee on Occupational Health: Providing Leadership in the Prevention of Workplace Illnesses and Injuries to Anesthesiologists and Their Patients
Robert S. Holzman M.D., M.A. (Hon.), FAAP, Chair Committee on Occupational Health
The mission of the Committee on Occupational Health (COOH) is to monitor, synthesize, evaluate and generate new knowledge in the field of occupational safety and health and to disseminate that knowledge and specific practice recommendations for the betterment of anesthesiologists and their patients.
The COOH is organized into task forces dedicated to specifically identified areas.
Task Force on Infection Control
(Chair: Robin Stackhouse, M.D.,
University of San Francisco, California [UCSF])
• Attention has been acutely focused in the past year on infection control issues with specific relevance to anesthesia practice. Fungal infections directly affecting the care provided by anesthesiologists for pain management (e.g., New England Compounding Center) as well as health care-associated hepatitis have been critical areas of focus this year. While the specifics still need to be worked out, anesthesia personnel have potentially a much greater role in reducing health care-associated infections than most people likely believe. In the future, greater efforts at education, changes in work practices and, where possible, engineering methods to reduce the risks of microbial transmission to our patients, should involve anesthesiologists as leaders.
This topic was an acute focus of the 2012 ASA annual meeting, involving material contributions from, among many others, representatives from the COOH.
• 2013 annual meeting activities: panel session:
“Germs and Drugs: Medication Safety”
Moderator: Robin Stackhouse, M.D.
USP: how does it affect your life?
Pharmacist: Renee Navarro, PharmD, M.D., UCSF
Prefilled syringes: are they worth it?
Harriet Hopf, M.D.
Brief update on infection control in
Richard Beer, M.D.
Task Force on Chemical Dependency
(Chair: Keith Berge, M.D., Mayo Clinic)
• The task force continues to be involved with the national effort in creating a “matrix” for the appropriate return of a physician with a history of substance abuse to practice.
• An active area of concern is the public health aspect of diversion with regard to infection control. As a society that has on its homepage, “Our members are leaders in patient safety,” ASA should take the high road in defending the public, lest we risk being viewed as another parochial trade organization.
• 2013 annual meeting activities 2013: “One Strike, You’re Out? Should the Narcotic Addict in Recovery Be Allowed to Return to Work in the O.R.?” There appears to be a trend at many of our institutions to deal with drug-diverting addicts with immediate termination of employment.
Is this appropriate? How can this be better handled?
(Keith Berge, M.D. and Michael Fitzsimons, M.D.)
• Refresher Course (2013): “Chemical Dependency and Anesthesiology” (John Tetzlaff, M.D.)
Task Force on Physician Wellness
(Chair: Gail Randel, M.D., Northwestern University)
• The Wellness Initiative has a new presence on the ASA website http://www.asahq.org/For-Members/Clinical-Information/Wellness-Initiatives.aspx, with a unique, new logo.
• Workshop (2013): “Clinical Wellness in the Workplace” (Neil Farber, M.D., Ph.D., moderator)
• Refresher Course (2013): “Mindfulness and Anesthesiology” (Robert Holzman, M.D.)
• Clinical Workshop (2013): “Practical Stress Management Techniques: A Quest for Physicians’ Well-Being”
(Haleh Saadat, M.D., moderator)
• Clinical Workshop (2013): “Mastering Stress, Preventing Burnout and Promoting Resilience for Anesthesiologists and Perioperative Physicians” (Kenneth Sapire, M.B., moderator)
Task Force on the Aging Anesthesiologist
(Chair: Fredrick Orkin, M.D., M.B.A., Yale)
• Two important manuscripts were published in 2012:
Garfield J, Garfield F, Holzman R, Mitani A, Tsen L. Practice policies for older anesthesiologists in academic departments: a national survey of academic departmental chairpersons. J Clin Anesth. 2012; 24:
Orkin F, McGinnis S, Forte G, Peterson M, Schubert A, Katz J, Berry A, Cohen N, Holzman R, Jackson S, Martin D, Garfield J. U.S. anesthesiologists over 50: retirement decision-making and workforce implications. Anesthesiology. 2012; 117:953-63.
• The task force will revise and update the initial survey leading up to the Anesthesiology publication and re-survey the membership. This will be of particular interest given the presumptive influence of the economy on the workforce in the last five years.
Task Force on Physical Hazards
(Chair: Andres T. Navedo-Rivera, M.D., Harvard)
The NIOSH Health and Safety Practices Survey of Healthcare Workers report was completed in collaboration with more than 1,300 ASA members and delivered during the 2012 annual meeting. It is a wealth of information about concerns that are significant for anesthesiologists in daily practice and will be the subject of a separate report.
Numerous inquiries continue to be directed to members of the Committee on Occupational Health about infection control, disability, return-to-work issues and wellness-related concerns regarding fatigue, stress, burnout and interpersonal relations such as bullying and confrontation in the workplace. The Committee on Occupational Health remains vigorously engaged in areas of vital importance to work-related issues in anesthesiology practice and welcomes any further areas of interest to our colleagues all over.
Robert S. Holzman, M.D., M.A. (Hon.), FAAP is Professor of Anaesthesia,
Harvard Medical School, Boston.
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