Search

Hospitals should review their local standards to ensure that they are harmonised with the relevant national safety standards, such as the National Safety Standards for Invasive Procedures in England (NatSSIPs) or the Scottish Patient Safety Programme in Scotland.^43,44

There should be sufficient numbers of clinical programmed activities in clinicians’ job plans to provide cover for all elective thoracic operating lists and to provide adequate emergency cover.⁴⁵

Service developments outside the operating theatre often place unintended demands on anaesthetists. The business plans for such services should include provision for anaesthetic services.

Most research in thoracic anaesthesia will be undertaken in specialist cardiothoracic units and should be given high priority.

Regular clinical audit of the work of thoracic anaesthesia services is essential. This might also include submission of data to national audits, such as the ACTACC national audit project, which includes thoracic anaesthesia topics. Information technology support should be available for such activities.^46,47

All thoracic units should have regular morbidity and mortality meetings. These meetings should be provided with a list of patients to discuss in advance, an attendance register, and minutes with learning points. Consultants or autonomously practising anaesthetists should attend these meetings and they should be included in job plans. Trainees should be encouraged to attend during their attachments.

Robust procedures should be in place to report and investigate adverse incidents involving equipment, staff or patients. The published outcomes of these investigations should be disseminated to all relevant anaesthetists and others.

Units with preassessment clinics should attempt to take part in research looking at preoptimisation and prehabilitation.

Booklets providing information for patients about their stay in hospital should be available for all patients. This will include the patient information booklets published by the British Thoracic Society on lung disease and the Roy Castle Lung Cancer Foundation for information about lung cancer and its surgical treatment. Sources of information about the anaesthetic should also be available.^{3,48,49,50,51,52}