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The American Society of Anesthesiologists is an educational, research and scientific association of physicians organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.

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N. Martin Giesecke, M.D., Chair

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September 1, 2013 Volume 77, Number 9
International Exchange: ASA Strengthening Relationships Across the Globe


For the third straight year, ASA and the European Society of Anaesthesiology (ESA) participated in a reciprocal arrangement in which each society provides representatives to their respective annual meetings. On June 3 in Barcelona, Spain, several ASA leaders led an ASA guest session at Euroanaesthesia 2013 titled “Patient Safety and Quality Improvement in Perioperative Care – The U.S. Perspective.”


The session was attended by more than 300 physicians. ASA President John M. Zerwas, M.D. provided an introduction to the session, which was chaired by ASA Committee on Annual Meeting Oversight Chair, Audrée A. Bendo, M.D.


“Deepening our relationships with our colleagues around the world has been a top priority of ASA in the last few years,” said Dr. Zerwas. “The outstanding educational and information interchange taking place between ASA and ESA at Euroanaesthesia 2013 is a highlight of our international efforts. And we look forward to seeing our European friends at the ASA annual meeting this October in San Francisco.”

Specific talk titles and their presenters were:


  • “Medical Decision Making,” Avery Tung, M.D., Chicago, Illinois
  • “Preventing Complications and Improving Outcomes in Orthopedic Procedures,” Andrew D. Rosenberg, M.D., New York, New York
  • “Learning From Medical Accidents,” Michael O’Connor, M.D., Chicago, Illinois


  • The session focused on the increased attention being paid to patient safety and quality improvement during the last decade – and to the fact that the United States’ health care system has not consistently achieved the desired high levels of safety and quality expected by patients and health care workers. Participants emphasized the changing focus from the epidemiology of errors and adverse events to the implementation of practices that reduce such events. Also discussed was a structured approach to improving patient safety and quality in perioperative care by medical decision-making, preventing complications and learning from medical accidents.


    Highlights of Dr. Tung’s “Medical Decision-Making” talk included recognition of the high rates of guideline noncompliance and unexplained practice diversity, which has focused attention on improving physician decision-making behavior. Dr. Tung addressed the fact that although the rate of decision error in anesthesiology is unknown, U.S. closed claims data suggest a high incidence of adverse events related to delays in diagnosis or treatment. While an initial step toward improving decision quality is identifying a “correct” decision, Dr. Tung said, the definition of “correct” can be extremely challenging. Hindsight bias, diverse physician and patient preferences, an evolving evidence base, and nonrational decision factors such as regret can make it difficult to reasonably identify ideal physician decision behavior even when the evidence base is strong.


    In his talk “Preventing Complications and Improving Outcome in Orthopedic Procedures,” Dr. Rosenberg addressed the role anesthesiologists can play in improving outcomes in patients undergoing orthopedic surgery. Using recent data on patients undergoing hip and knee surgery, Dr. Rosenberg indicated that neuraxial anesthesia techniques are associated with a lower incidence of perioperative complications than general anesthesia. Regional anesthesia for radius fracture repair is associated with less pain and better range of motion at three months, as is spinal anesthesia for ankle fracture. He also mentioned that recent data on postoperative visual loss indicate that it may be more frequent in males, obese patients, longer procedures, operations with greater blood loss, use of the Wilson frame and with less use of colloids.


    Dr. O’Connor presented “Learning From Medical Accidents,” which concerned the scholarship of medical accidents. He reviewed the literature from medicine and other domains, which shows that medical accidents have multiple causes. Dr. O’Connor talked about how the problem of hindsight bias focuses the attention of journalists and regulators on the performance of practitioners, thus preventing them from seeing and understanding all of the other causes of accidents. Such a focus on practitioner performance in turn generates responses to accidents that fail to address most of their causes – and often their most important causes.


    Strong Presence in the Exhibit Hall


    ASA also was well represented in the exhibit hall at Euroanaesthesia 2013. The ASA booth received considerable attention from scores of attendees. ASA representatives in the booth reported that the Society’s recent efforts to brand ASA and promote the ASA annual meeting to the global marketplace are clearly paying off.


    “ASA’s participation in the ESA Annual Scientific Meeting enabled ASA staff and leadership the opportunity to meet physicians from all over the world who – if they were not already ASA members – were interested in becoming members. We were excited to learn that many of them will be attending our annual meeting in San Francisco this year or the 2014 meeting in New Orleans,” said ASA CEO Paul Pomerantz, who along with Chris Wehking, ASA’s Director of Meetings and Exhibits, and Sara Moser, ASA’s Director of Corporate Development, also spent quality time with corporate executives from industry.


    At the ANESTHESIOLOGY™ 2013 annual meeting in San Francisco, which is appropriately themed “Global Partners in Quality Outcomes and Patient Safety,” on Monday, October 14, ESA members will present their panel on “Harmonizing Anesthesiology as a Specialty in Europe.” ESA panel speakers include ESA President Professor Eberhard F. Kochs, M.D., (Germany), ESA Secretary Professor Andreas Hoeft, M.D. (Belgium), Professor Stefan De Hert, M.D., Chair, ESA Scientific Committee (Belgium), and ESA President-Elect Professor Daniela Filipescu, M.D. (Romania).






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