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We developed an innovative method to teach systems-based practice through a team-based project initiative. The projects appear to have had a positive impact on our health care organization. Our assessment tool for the project evaluated team, rather than individual, performance, which is crucial in this competency.

We report a 7-year-old child who underwent brain MRI for a known seizure disorder. The technique used for general anesthesia included inhalation induction followed by placement of a laryngeal mask airway (LMA) for airway maintenance. Because the reviewing radiologist was unfamiliar with the use of an LMA during anesthesia, and because the attending anesthesiologist did not communicate his technique to the radiologist, an MRI misdiagnosis was reported because of artefact created by the in situ LMA. As a result of this misdiagnosis the child was subjected to unnecessary subsequent testing to rule out a reported anatomic abnormality induced by the LMA. Our case illustrates the need for coordination of patient care among hospital services.

In 2010, our department instituted a nonclinical, administrative rotation in operating room management for anesthesiology residents. Subsequently, we mandated the rotation for all senior anesthesiology residents in 2013. In 2014, under the auspices of the American Society of Anesthesiologists, we developed a web-based module covering the basics of finance, accounting, and operating room management. A multiple-choice test was given to residents at the beginning and end of the rotation, and we compared the mean scores between residents who took the traditional course and residents who took the web-based module. We found no significant difference between the groups of residents, suggesting that the web-based module is as effective as traditional didactics.

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