ASA June 2003 Newsletter

In 1995, the ASA Committee on Professional Liability’s Closed Claims Project established its presence on the World Wide Web. In 1997, the project added abstracts of all its journal articles to its Web site as well as the full text of its ASA NEWSLETTER articles (with ASA’s permission). In 2000, the project acquired its own Web domain name <www.asaclosedclaims.org> and received permission to display its ASA Refresher Course Lectures. Through these actions, the project remains a key source for research on the subject of malpractice loss and patient injury in the anesthetic setting.

Malpractice and Patient Injury Examined Online
The Closed Claims Project is actually four ventures, and the Web site reflects this organization. One section of the Web site is devoted to the Committee on Professional Liability and includes links to articles that its members have published on the subject of malpractice liability. Another section covers the Closed Claims Project, the goal of which is to identify major areas of loss in anesthesia, patterns of injury and strategies for prevention. The Web site also presents articles for the Pediatric Perioperative Cardiac Arrest (POCA) Registry. Created in 1994, the POCA Registry investigates the possible relationship of anesthesia to cardiac arrests and death in pediatric patients. Lastly, there is a section devoted to the Postoperative Visual Loss (POVL) Registry, which was created in 1999. The POVL Registry investigates the mechanism of perioperative ischemic optic neuropathy (ION). This section includes the registry’s bibliography, educational handouts and the actual clinical data questionnaire.

Physicians are encouraged to download this material and anonymously submit cases of ION to the registry. Patients also may submit cases provided that all patient, provider, hospital and clinic names are obscured. Instructions on how to submit cases are provided on the Web site.

Saving Money
Distributing publications online is an excellent way to reduce administrative costs as it leads to a reduction in reprint and mailing charges and storage requirements. Print-cost reduction is especially important for the POVL Registry, which includes several publications in which retention of the color schema is essential. Online distribution of these materials is an effective means to reduce staffing hours and costs and still provide practitioners and patients with the information they need.

Increasing Readership
Readership continues to increase each year. In 1997, our Web site had 400 visitors each month. In 2001, it reached 600 per month. In January 2003 alone, 1,000 users visited. Considering the specificity of our information, to have 12,000 visitors each year interested in perusing articles on patient injury in the anesthetic setting is quite remarkable.

Visitors can view articles either through the Closed Claims Project’s online bibliography or its series of predesigned subject categories. In addition, many commercial search engines have indexed our site for online searching. Regardless of how you do your Web browsing, if you are searching for information on nerve damage, ION, airway injuries or anesthetic instrumentation mishaps, you will likely run across one of the project’s articles.

More than 70 percent of our U.S. visitors use commercial Internet service providers (ISP) to access our Web site. Less than 10 percent are from educational, governmental or nonprofit agencies in the United States that have their own ISPs. Other visitors come from Australia, Bulgaria, Canada, Italy, Japan and the United Kingdom.

Contacting the Project
ASA members may request aggregate analyses of the project’s data. Raw data will not be provided for independent analysis. These analyses are provided for the education of the membership but generally are not for publication. Instructions on how to request such analyses are provided on the Web site. ASA members may wish to examine the articles provided on the Web site in order to formulate questions of interest.

The project’s Web site can answer most general questions about our goals and research. Specific questions and comments about the ASA Closed Claims Project are always welcome, and you can e-mail these questions to Karen Posner, Ph.D., at <posner@u.washington.edu>. Technical questions or comments about the Web site should be addressed to the author at <asaccp@u.washington.edu> or may be submitted via our online survey at <www.asaclosedclaims.org>. The project staff will make every effort to answer your questions in a timely manner.

John Campos, M.A., is Research Consultant, University of Washington, Seattle, Washington. Mr. Campos provides Web site and research support to the ASA Closed Claims Project.

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