DOI: 10.1097/01.sa.0000132002.25233.0a

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Issn Print: 0039-6206

Publication Date: 2004/08/01


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Resident Training and Quality of Anesthesia Care in a University Hospital

Kathryn E. McGoldrick

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Resident Training and Quality of Anesthesia Care in a University Hospital Karen L. Posner,*† and Peter R. Freund‡
(Anesth Analg, 98:437-442, 2004)
*Departments of Anesthesiology and †Anthropology, University of Washington and ‡Anesthesia Clinical Services, University of Washington, Seattle, WA.
The relationship between resident training and patient safety in anesthesia was analyzed. A retrospective quality improvement database review was used to calculate the relative risk of any quality problem and specific types of quality problems (ie, injury, escalation of care, or operational inefficiency) between anesthesia teams with CA1, CA2, and CA3 residents. The expectation was that teams with less experienced residents (CA1) would have more quality problems than teams with more experienced residents (CA2 and CA3). Data revealed that the risk of injury did not differ between teams. CA2 teams had higher rates of critical incidents and escalation of care than CA1 and CA3 teams. The CA2 year is a time when residents move into specialty training, which requires more advanced skills and a larger knowledge base. The greater relative risk for critical incidents, escalation of care, and operational inefficiencies may reflect lack of experience, uncertainty, and less mastery of skills compared with CA3 residents. The greater inefficiency and escalation of care rates associated with CA2 teams may lead to higher costs for the institution.
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