Risk reduction in anesthesia and sedation—An analysis of process improvement towards zero adverse events

INTRODUCTION: Anesthesia is a complex domain that is highly technical and skill based. Primary Care Physicians often have to do the initial evaluation of surgical patients they encounter during their daily practice before referring them to the surgical team. Thus, the Primary Care Physician's preliminary knowledge in anesthesia processes, risks involved and interventions that can be done to minimize these risks can improve patient-centered care and ultimately patient safety. MATERIALS AND METHODS: The study was conceptualized and conducted in the Department of Anesthesiology from January 2018 to December 2018 in a 600 bed Multispecialty teaching hospital in Bihar, India. The study aimed towards Anesthesia Care related Risk Identification and Reduction and encompassed process improvements. RESULTS: Risk Severity Analysis of the Critical Steps of Anesthesia Care was done. The average Hazard Score reduced from 21.59 during January 2018 to March 2018 to 8.23 during April 2018 to June 2018 subsequently to 3.53 during July 2018 to September 2018 and finally to 2.12 during October 2018 to December 2018. Thus, there was an overall reduction of 90.18% in the Hazard Score from April'18 to June'18 quarter to October 2018 to December 2018 quarter. CONCLUSION: Adverse Anesthesia/Sedation Events reported during the period from January 2019 to December 2019 was “Zero”. A systematic approach towards Risk Reduction not only lead to reduction in Hazard Score and Process Improvement but also made the Anesthesia Care Safe which is evident in the consistency of reporting “Zero” Adverse Anesthesia/Sedation Events for the last one year.