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Anesthesia Patient Risk: A Quantitative Approach to Organizational Factors and Risk Management Options

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  • M. Elisabeth Paté‐Cornell
  • Linda M. Lakats
  • Dean M. Murphy
  • David M. Gaba

Abstract

The risk of death or brain damage to anesthesia patients is relatively low, particularly for healthy patients in modern hospitals. When an accident does occur, its cause is usually an error made by the anesthesiologist, either in triggering the accident sequence, or failing to take timely corrective measures. This paper presents a pilot study which explores the feasibility of extending probabilistic risk analysis (PRA) of anesthesia accidents to assess the effects of human and management components on the patient risk. We develop first a classic PRA model for the patient risk per operation. We then link the probabilities of the different accident types to their root causes using a probabilistic analysis of the performance shaping factors. These factors are described here as the “state of the anesthesiologist” characterized both in terms of alertness and competence. We then analyze the effects of different management factors that affect the state of the anesthesiologist and we compute the risk reduction benefits of several risk management policies. Our data sources include the published version of the Australian Incident Monitoring Study as well as expert opinions. We conclude that patient risk could be reduced substantially by closer supervision of residents, the use of anesthesia simulators both in training and for periodic recertification, and regular medical examinations for all anesthesiologists.

Suggested Citation

  • M. Elisabeth Paté‐Cornell & Linda M. Lakats & Dean M. Murphy & David M. Gaba, 1997. "Anesthesia Patient Risk: A Quantitative Approach to Organizational Factors and Risk Management Options," Risk Analysis, John Wiley & Sons, vol. 17(4), pages 511-523, August.
    • Handle: RePEc:wly:riskan:v:17:y:1997:i:4:p:511-523
    DOI: 10.1111/j.1539-6924.1997.tb00892.x
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    References listed on IDEAS

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    1. M. Elisabeth Paté‐Cornell & Robert G. Bea, 1992. "Management Errors and System Reliability: A Probabilistic Approach and Application to Offshore Platforms," Risk Analysis, John Wiley & Sons, vol. 12(1), pages 1-18, March.
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    Cited by:

    1. Elisabeth Paté‐Cornell, 2002. "Finding and Fixing Systems Weaknesses: Probabilistic Methods and Applications of Engineering Risk Analysis," Risk Analysis, John Wiley & Sons, vol. 22(2), pages 319-334, April.
    2. Reza Kazemi & Ali Mosleh & Meghan Dierks, 2017. "A Hybrid Methodology for Modeling Risk of Adverse Events in Complex Health‐Care Settings," Risk Analysis, John Wiley & Sons, vol. 37(3), pages 421-440, March.
    3. Elisabeth Paté‐Cornell & Louis Anthony Cox, 2014. "Improving Risk Management: From Lame Excuses to Principled Practice," Risk Analysis, John Wiley & Sons, vol. 34(7), pages 1228-1239, July.
    4. Elisabeth Paté‐Cornell, 2012. "On “Black Swans” and “Perfect Storms”: Risk Analysis and Management When Statistics Are Not Enough," Risk Analysis, John Wiley & Sons, vol. 32(11), pages 1823-1833, November.

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