What defines the ideal anesthesia care team is a contentious issue. American Society of Anesthesiologists President J. P. Abenstein, MSEE, MD, weighs in the role CRNAs can play and what the model ambulatory surgery center's anesthesia team looks like.
Question: What role can CRNAs play in an ASC's anesthesia team?
Dr. J. P. Abenstein: The physician-led anesthesia care team is an important method by which the highest quality and safest medical care is delivered to our patients whether the surgery or procedure takes place in a hospital or ambulatory surgery center. Nurse anesthetists and anesthesiology assistants are critical members of the physician-led anesthesia care team. They are highly trained and bring their skills, knowledge and experience to deliver high-quality and safe anesthesia care as part of the physician-led anesthesia care team. In academic practices, resident physicians are also part of the physician-led anesthesia care team.
Many anesthesiology departments around the country use physician-led anesthesia care teams when caring for patients undergoing surgery or other procedures requiring anesthesia. These teams deliver high quality, cost-effective and safe patient care. In addition, this practice model is flexible, allowing for the delivery of anesthesia care where and when needed by our patients. As the demand for procedural care, and by extension anesthesia care, increases secondary to demographic changes and advances in medicine, it's reasonable to expect an increase in the use of physician-led anesthesia care teams, including anesthesiology assistants, nurse anesthetists and resident physicians.
The purpose of the American Society of Anesthesiologists and its more than 52,000 members is to ensure that each patient receives the highest quality and safest medical care possible during a risky time in their life. Evidence of our commitment to high quality, safe medical care is our Anesthesia Quality Institute and its registries, which have reported a reduction in anesthesia-related complications since its inception in 2009 of more than 50 percent.
Q: What does the ideal ASC anesthesia team look like?
JPA: Whether their surgery or procedure requires an overnight stay at a hospital or takes place at an ambulatory surgery center, all patients should insist on understanding "who is going to be taking care of me during my surgery or procedure." A patient's pre-operative, intraoperative and immediate post-operative care should be coordinated and led by a physician anesthesiologist, or delivered by a physician anesthesiologist. The anesthesia care team model is physician-led, but has flexibility to allow the physician to be involved in the case that best meets the needs of the patient. For example, a patient with several severe co-morbidities scheduled for open heart surgery might have a physician anesthesiologist dedicated to the care of a single patient. While for a healthy patient scheduled for relatively minor surgery, the physician may be supervising the care of several patients. This allows for alignment of the right care for the right patient at the right time. The bottom line is that there is meaningful risk associated with anesthesia and a physician-led team approach with flexibility is critical when considering the anesthesia care team.