our ASA Quality Management and Departmental Administration Committee (QMDA) met in Dallas, Texas, on Saturday and Sunday, January 19-20, 2008. The committee usually holds two meetings per year; a shorter one during the ASA Annual Meeting and an extended one sometime during the first three months of the year.

This year’s winter meeting was, as usual, filled with business brought to the committee from a variety of sources. These include responsibility for all matters pertaining to anesthesia quality and peer review; representation of the Society to all regulatory bodies on which ASA has a designated member (The Joint Commission, the American Association for Accreditation of Ambulatory Surgery Facilities and the Accreditation Association for Ambulatory Health Care); management and operation of the ASA Consultation Program; and the provision of numerous services directly to members, including quality management templates and the Manual for Anesthesia Department Organization and Management (MADOM), found in the “Members Only” section of the ASA Web site, response to member inquiries regarding quality management in their departments, and assistance to ASA leadership in responding to professional, regulatory, and governmental entities on matters pertaining to anesthesia quality.

Major changes continue to take place in the management, manual and method of The Joint Commission (formerly JCAHO). A new leader, Mark R. Chassin, M.D., M.P.P., M.P.H., has taken over from long-term president Dennis S. O’Leary, M.D. Insiders are awaiting the changes in policy that will almost certainly come with his new leadership (although Dr. O’Leary will continue as president emeritus). More comforting to anesthesiologists, however, is the knowledge that Rebecca J. Patchin, M.D. — a member of the Board of Trustees of the American Medical Association (from ASA) and a California anesthesiologist — has been appointed the AMA’s representative to the board of directors of The Joint Commission, ensuring that a watchful eye will now monitor its proceedings as they may affect anesthesiologists.
Recently, Jerry A. Cohen, M.D., stepped down after a six-year term as ASA representative to the Hospital Professional and Technical Advisory Committee (PTAC) of The Joint Commission. The committee commended Dr. Cohen for his untiring efforts on behalf of ASA at the oftentimes divisive sessions of this group. Robert S. Lagasse, M.D., former alternate Hospital PTAC representative, has been appointed to replace Dr. Cohen. Walter G. Maurer, M.D., will continue his service as Ambulatory PTAC representative, while Donald E. Arnold, M.D., and Mark A. Singleton, M.D., respectively, back them up as alternates.

Dr. Maurer reported that there may be upcoming field reviews concerning The Joint Commission chapter on “Patient Rights and Patient Care.” Should ASA need substantial input to The Joint Commission on this or other proposed policies, QMDA is prepared to contact ASA members on a large scale to afford The Joint Commission a clear message of our position. Dr. Lagasse reported that his PTAC will soon be reviewing the “Medication Management Chapter,” which is of special concern to ASA, since the standards The Joint Commission establishes for the entire hospital often are inappropriate when applied to the operating room and anesthesiologist functions. For this reason, The Joint Commission is considering forming an expert panel to obtain input specific to our needs. QMDA will be prepared to supply expert advice to any such advisory group.

The ASA Consultation Program, established in 1982 by action of the House of Delegates, recently completed its 190th consultation. The program provides two expert reviewers who go on site to hospitals and departments who formally request the services of ASA to analyze quality issues. William H. Montgomery, M.D., currently serves as program director and receives and analyzes requests for assistance to determine the most appropriate means of assisting ASA members and their institutions in achieving the highest level of anesthesia quality. This January’s meeting devoted substantial time to a detailed look at the consultation format, procedures and report in an effort to maintain its position as the “gold standard” of anesthesia quality consultative services. Judith Jurin Semo, J.D., will replace long-time consultation program counsel Karin Bierstein, J.D., as the program’s legal reviewer, and ASA Washington staff member Sharon K. Merrick, CCS-P, has assumed liaison responsibilities, along with our new incoming Associate Director of Practice Management and Quality Initiatives Jason Byrd, J.D. Sandra Cincotti in the Park Ridge office will continue to be the administrative manager and Susan Birk our editorial consultant.

The committee’s primary publication, MADOM, recently underwent its biannual revision and was published on the Web just prior to the ASA 2007 Annual Meeting in San Francisco. Plans for the 2009 revision will begin at the 2008 meeting in Orlando, and the committee elected to add an additional chapter on “Disaster Preparedness” to be edited by committee member Peter J. Dunbar, M.D., who also chairs the ASA Committee on Trauma and Emergency Preparedness.

Other topics discussed included an update on the ever-confusing “locked carts policy,” discussion of the quality ramifications of Aetna’s recent policy on reimbursement for colonoscopy, the Centers for Medicare & Medicaid Services’ (and other payers’) decision not to pay for “things that should never happen,” the current status of ASA’s efforts to take leadership in the prevention of wrong-site surgery, and a review of the committee’s ASA Web site offering of the Quality Management Template.

QMDA remains one of ASA’s most active and productive committees. Your chair wishes to thank all members for their continued contributions and service and extends a special thanks to ASA President Jeffrey L. Apfelbaum, M.D. (a former QMDA chair himself), ASA officers, Sharon K. Merrick and the many ASA staff members who provide our very appreciated support.

James S. Hicks, M.D., is Adjunct Associate Professor of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland.