May 1, 2013
Volume 77, Number 5
What's New In... Update From the 2012-13 ASA Committee on Standards and Practice Parameters
Jeffrey L. Apfelbaum, M.D., Chair, Committee on Standards and Practice Parameters
The mission of the Committee on Standards and Practice Parameters (CSPP) is to offer guidance to the ASA membership by providing educational and scientific information related to the safe and effective practice of anesthesiology. As part of this mission, the CSPP develops evidence-based guidelines and advisories as well as practice standards, alerts and other consensus-based documents. To further promote safe anesthesia practice, the CSPP evaluates patient care documents developed by other health care organizations. The duties of the committee as defined in the ASA Administrative Procedures include:
n Recommending to the ASA leadership the development of future practice parameters (standards, guidelines, advisories and alerts) for patient care in areas normally considered the purview of the anesthesiologist.
n Providing oversight for the development of all practice parameters by any ASA-appointed task forces.
n To interact with appropriate committees of ASA and solicit broad-based physician input from ASA members as new, revised or updated practice parameters are proposed and debated.
n Recommending approval/disapproval of all practice parameter drafts prior to presentation to the Board of Directors and the House of Delegates.
n Publication or dissemination of the established practice parameters to members of this Society and to individuals, private organizations and government agencies.
n Monitoring the adoption and/or publication of practice parameters by other organizations of health care providers related to the practice of anesthesiology.
n Review and recommend approval/disapproval for ASA endorsement or support of practice parameters developed by other organizations that may affect the practice of anesthesiology.
“Regular” members of the 2012-13 CSPP include Jeffrey L. Apfelbaum, M.D., Chair, Casey D. Blitt, M.D., John F. Butterworth IV, M.D., Robert A. Caplan, M.D., Joseph F. Cassady, Jr., M.D., Daniel J. Cole, M.D., Jesse M. Ehrenfeld, M.D., Tong J. Gan, M.D., Carin A. Hagberg, M.D., Linda B. Hertzberg, M.D., Tae Whang Kim, M.D., Martin London, M.D., Donald E. Martin, M.D., Christine S. Park, M.D., Johnathan L. Pregler, M.D., Armin Schubert, M.D., M.B.A., and David Varlotta, D.O.
Due to the complex nature of business conducted by the committee, there are an additional number of ex-officio members who communicate regularly with other ASA standing committees. These include: Lee Fleisher, M.D. (Committee on Performance and Outcomes Measurement), Robert E. Kettler, M.D. (Committee on Professional Liability), Tom C. Krejcie, M.D. (Committee on Equipment and Facilities), Alan P. Marco, M.D. (Committee on Patient Safety and Education) and Beverly K. Philip, M.D. (Committee on Quality Management and Departmental Administration).
In 2012, CSPP produced three new updated documents, approved by the ASA House of Delegates on October 17, 2012:
“Practice Guidelines for Management of the Difficult Airway: An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway,” published in the February 2013 issue of Anesthesiology.
“Practice Guidelines for Postanesthetic Care: An Updated Report by the American Society of Anesthesiologists Task Force on Postanesthetic Care,” also published in the February 2013 issue of Anesthesiology.
“Practice Advisory for the Management of Operating Room Fires: An Updated Report by the American Society of Anesthesiologists Task Force on Operating Room Fires,” also published in the February 2013 issue of Anesthesiology.
The 2012-13 committee has undertaken yet another ambitious agenda: three separate task forces have begun revisions or updates to the following current ASA Practice Parameters: 1) “Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea”; 2) “Practice Guidelines for Perioperative Blood Transfusion and Adjuvant Therapies”; and 3) “Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists.” We expect drafts of these practice parameters to be posted on the ASA website during spring and summer 2013. All ASA members are encouraged to review the drafts and provide input to the respective task forces.
Since 1992, twenty-two evidence-based practice parameters and 17 updates have been approved and published in Anesthesiology. These practice parameters are reviewed annually by the National Guidelines Clearinghouse (NGC), and 13 ASA documents are currently listed on its website
In accordance with the ASA Administrative Procedures, the committee completed its scheduled five-year review of the following ASA-approved documents: “Statement on Routine Preoperative Laboratory and Diagnostic Screening” (2008); “Policy Statement on Practice Parameters” (2008); and “Statement on Non-operating Room Anesthetizing Locations” (2008). The committee voted to retire the document
“Statement on Routine Preoperative Laboratory and Diagnostic Screening” (2008) due to the publication of the document “Practice Advisory for Preanesthetic Evaluation” in Anesthesiology in 2012. The committee also recommended minor revisions to the other two documents.
As previously indicated, ASA standards, guidelines, practice advisories, and statements provide guidance to improve decision-making and promote beneficial outcomes for the practice of anesthesiology. They are not intended as unique or exclusive indicators of appropriate care. The interpretation and application of standards, guidelines, practice advisories and statements take place within the context of local institutions, organizations and practice conditions. A departure from one or more recommendations may be appropriate if the facts and circumstances demonstrate that the rendered care met the physician’s duty to the patient.
On behalf of the entire committee, we would like to express our profound appreciation to Richard T. Connis, Ph.D. and David G. Nickinovich, Ph.D., the two scientific methodologists whose full-time work is dedicated to assisting this committee in fulfilling its mission. Without their efforts, it would be impossible to fulfill our charge.
Jeffrey L. Apfelbaum, M.D. is Professor and Chair, Department of Anesthesia and Critical Care, University of Chicago, Pritzker School of Medicine, Chicago.
He was ASA President in 2008.
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