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British Journal of Anaesthesia Sep 2023Shaw and colleagues, who are medical historians, have published a detailed review of the social history of the British Journal of Anaesthesia (BJA) to celebrate its...
Shaw and colleagues, who are medical historians, have published a detailed review of the social history of the British Journal of Anaesthesia (BJA) to celebrate its first 100 years. In this editorial, we note some additional contributions and financial details that are relevant to the development of the BJA into the international high-impact journal it is today.
Topics: Anesthesiology; United Kingdom; Publishing; Journal Impact Factor
PubMed: 37611971
DOI: 10.1016/j.bja.2023.05.024 -
British Journal of Hospital Medicine... Apr 2024The anaesthetic training programme in the United Kingdom (UK) spans over seven years and is overseen by the Royal College of Anaesthetists (RCOA). Junior doctors in... (Review)
Review
The anaesthetic training programme in the United Kingdom (UK) spans over seven years and is overseen by the Royal College of Anaesthetists (RCOA). Junior doctors in England are currently striking amid ongoing pay negotiations with the government, and almost all junior doctors are worried about the cost of living. This article provides an overview of the average financial cost of training for doctors in the anaesthetic training programme. The cost incurred by anaesthetic trainees illustrates the level of financial burden faced by trainees across multiple specialities. The cost includes: student loan repayment (with interest rates), compulsory membership fees (including the Royal College of Anaesthetists and General Medical Council), postgraduate examinations (Fellowship of the Royal College of Anaesthetist exams are compulsory to complete training) and medical indemnity. The average trainee spends between 5.6% and 7.4% of their annual salary on non-reimbursable costs. This article delineates for aforementioned expenses and compares them with the training programs in Australia and New Zealand, given their status as frequent emigration destinations for UK doctors.
Topics: Humans; Anesthesiology; United Kingdom; Education, Medical, Graduate; Australia; New Zealand; Salaries and Fringe Benefits
PubMed: 38708973
DOI: 10.12968/hmed.2023.0437 -
Seminars in Cardiothoracic and Vascular... Dec 2023Public health and the medical specialty of anesthesiology have been closely intertwined throughout history, dating back to the 1800s when Dr. John Snow used contact... (Review)
Review
Public health and the medical specialty of anesthesiology have been closely intertwined throughout history, dating back to the 1800s when Dr. John Snow used contact tracing methods to identify the Broad Street Pump as the source of a cholera outbreak in London. During the COVID-19 pandemic, leaders in anesthesiology and anesthesia patient safety came forward to develop swift recommendations in the face of rapidly changing evidence to help protect patients and healthcare workers. While these high-profile examples may seem like uncommon events, there are many common modern-day public health issues that regularly intersect with anesthesiology and surgery. These include, but are not limited to, smoking; chronic opioid use and opioid use disorder; and obstructive sleep apnea. As an evolving medical specialty that encompasses pre- and postoperative care and acute and chronic pain management, anesthesiologists are uniquely positioned to improve patient care and outcomes and promote long-lasting behavioral changes to improve overall health. In this article, we make the case for advancing the role of the anesthesiologist beyond the original perioperative surgical home model into promoting public health initiatives within the perioperative period.
Topics: Humans; Anesthesiologists; Public Health; Pandemics; Anesthesiology; Opioid-Related Disorders
PubMed: 37679298
DOI: 10.1177/10892532231200620 -
Anesthesiology Nov 2023Measuring and comparing clinical productivity of individual anesthesiologists is confounded by anesthesiologist-independent factors, including facility-specific factors... (Review)
Review
Measuring and comparing clinical productivity of individual anesthesiologists is confounded by anesthesiologist-independent factors, including facility-specific factors (case duration, anesthetizing site utilization, type of surgical procedure, and non-operating room locations), staffing ratio, number of calls, and percentage of clinical time providing anesthesia. Further, because anesthesia care is billed with different units than relative value units, comparing work with other types of clinical care is difficult. Finally, anesthesia staffing needs are not based on productivity measurements but primarily the number and hours of operation of anesthetizing sites. The intent of this review is to help anesthesiologists, anesthesiology leaders, and facility leaders understand the limitations of anesthesia unit productivity as a comparative metric of work, how this metric often devalues actual work, and the impact of organizational differences, staffing models and coverage requirements, and effectiveness of surgical case load management on both individual and group productivity.
Topics: Humans; Anesthesiologists; Efficiency; Anesthesiology; Anesthesia; Operating Rooms
PubMed: 37815474
DOI: 10.1097/ALN.0000000000004722 -
European Journal of Anaesthesiology Jul 2024
Topics: Humans; Europe; Anesthesiology; Anesthesia
PubMed: 38845575
DOI: 10.1097/EJA.0000000000001993 -
Journal of Clinical Monitoring and... Feb 2024Anesthesiology and intensive care medicine provide fertile ground for innovation in automation, but to date we have only achieved preliminary studies in closed-loop...
Anesthesiology and intensive care medicine provide fertile ground for innovation in automation, but to date we have only achieved preliminary studies in closed-loop intravenous drug administration. Anesthesiologists have yet to implement these tools on a large scale despite clear evidence that they outperform manual titration. Closed-loops continuously assess a predefined variable as input into a controller and then attempt to establish equilibrium by administering a treatment as output. The aim is to decrease the error between the closed-loop controller's input and output. In this editorial we consider the available intravenous anesthesia closed-loop systems, try to clarify why they have not yet been implemented on a large scale, see what they offer, and propose the future steps towards automation in anesthesia.
Topics: Humans; Anesthesiology; Anesthesia; Automation; Anesthesia, Intravenous; Infusions, Intravenous
PubMed: 37707703
DOI: 10.1007/s10877-023-01077-3 -
Anesthesiology Clinics Jun 2024
Topics: Humans; Anesthesia; Orthopedic Procedures; Orthopedics; Anesthesiology
PubMed: 38705683
DOI: 10.1016/j.anclin.2024.03.001 -
Anesthesia and Analgesia Mar 2024
Topics: Anesthesia; Anesthesiology
PubMed: 38364239
DOI: 10.1213/ANE.0000000000006476 -
British Journal of Anaesthesia Oct 2023The subjective experiences of sedation or anaesthesia are underexplored. A recent study by Valli and colleagues (Br J Anaesth 2023; 131: 348-59) found similar frequency...
The subjective experiences of sedation or anaesthesia are underexplored. A recent study by Valli and colleagues (Br J Anaesth 2023; 131: 348-59) found similar frequency and content of recalled experiences after both non-rapid eye movement sleep and target-controlled infusions of propofol or dexmedetomidine titrated to verbal unresponsiveness. The authors find that the phenomenological similarities between consciousness during sleep and sedation mirror their physiological similarities. Intriguingly, in this small sample, conscious experience did not show a dose-dependent response suggesting other factors are important in determining the propensity for consciousness under sedation.
Topics: Humans; Consciousness; Anesthesia; Sleep; Anesthesiology; Conscious Sedation
PubMed: 37718091
DOI: 10.1016/j.bja.2023.07.019 -
Current Opinion in Anaesthesiology Aug 2023Healthcare is increasingly expanding its view in outcome discussions to integrate patient-reported outcomes such as patient satisfaction. Involving patients in the... (Review)
Review
PURPOSE OF REVIEW
Healthcare is increasingly expanding its view in outcome discussions to integrate patient-reported outcomes such as patient satisfaction. Involving patients in the evaluation of services and the development of quality improvement strategies is paramount, especially in the service-oriented discipline of anaesthesiology.
RECENT FINDINGS
Currently, while the development of validated patient satisfaction questionnaires is well established, the use of rigorously tested scores in research and clinical practice is not standardized. Furthermore, most questionnaires are validated for specific settings, which limits our ability to draw relevant conclusions from them, especially considering the rapidly expanding scope of anaesthesia as a discipline and the addition of same-day surgery.
SUMMARY
For this manuscript, we review recent literature regarding patient satisfaction in the inpatient and ambulatory anaesthesia setting. We discuss ongoing controversies and briefly digress to consider management and leadership science regarding 'customer satisfaction'.
Topics: Humans; Anesthesiology; Patient Satisfaction; Anesthesia; Leadership; Surveys and Questionnaires
PubMed: 37222215
DOI: 10.1097/ACO.0000000000001270