An Analysis of Risk Factors for Patient Complaints About Ambulatory Anesthesiology Care

Abstract

There was apparent evidence in adult patients to suggest heterogeneity in provider risk for a patient complaint. However, once patient, procedural, and provider factors were acknowledged in analyses, such evidence for heterogeneity is diminished substantially. Further study into how and why these factors are associated with greater complaint risk may reveal potential interventions to decrease complaints.

Hypotension during induction of anaesthesia is neither a reliable nor a useful quality measure for comparison of anaesthetists’ performance

“…34 After controlling for relevant covariates including patient waiting from surgical start times, there were no significant differences in adult patients' complaints about anaesthetists. 35 Prolonged times to extubation differ substantively amongst patients, but not amongst anaesthetists. 36 Patients' arrival pain scores in the postoperative area also do not differ significantly, when controlling for other factors, such as the nurse recording the pain score.…”

Subcutaneous dissociative conscious sedation outside the operating theatre: prospective randomised double-blind study

“…sedation or even general anaesthesia to achieve patient comfort and optimal situation to prevent failure of the procedure [1][2][3][4] . In addition, most patients undergoing gastrointestinal interventions are outpatients and a short PACU admission period is desirable [4][5][6][7] . Conventional regimens including a combination of benzodiazepines and opioids have been used to provide analgesia and amnesia.…”

Litigation and complaints associated with day-case anaesthesia

“…Studies provide some evidence of factors that increase the risk of complaints or litigation in anaesthesia for day surgery. Kynes et al 4 examined risk factors associated with patient complaints in day-case anaesthesia. Of the 22 871 follow-up calls made, 307 (1.34%) yielded a complaint.…”

“…Despite potential clinical benefits, RA is associated with relatively more litigation than GA. 2,6 Avoidance of GA is also associated with more patient complaints in ambulatory care. 4 RA offers benefits to patients undergoing day surgery, including rapid return to normal functioning and prolonged post-discharge analgesia. Ophthalmic surgery and orthopaedic extremity surgery are particularly suited as a result of patient frailty and the need for prolonged analgesia.…”