For children, a staff member with an advanced paediatric life support qualification or an anaesthetist with paediatric competencies should be immediately available.180
Core competencies should be updated according to local and national guidelines.
Wherever possible, training should be provided in a multidisciplinary format.192
Business planning by hospitals and anaesthetic departments should ensure that the necessary time and resources are directly targeted towards preoperative preparation.71
A well-designed preoperative service should minimise patient delays through the journey to surgery, while allowing appropriate time for initiation of interventions likely to improve patient outcome. By optimising planning of patient care, with the right staff and resources available, cancellations can be reduced and the efficiency of operating lists improved.
Anaesthetists should participate in departmental audit and quality improvement projects, using specific, measurable, attainable, relevant and time-bound (SMART) methodology (see Glossary) and consideration of full audit cycles (e.g. plan, do, study, act). This participation should adhere to the standards and principles outlined in the College’s Raising the Standards: RCoA Quality Improvement Compendium.5
There should be a multidisciplinary and cross specialty programme for auditing intraoperative care.
A system for reporting and regular audit of critical incidents and near misses is an essential part of a well-led safety structure, and there should be multiprofessional involvement in this. The methodology must be explicit and identify underlying relevant factors to inform learning and development of safe systems. All staff must recognise the duty of candour and foster a culture...
Anaesthetists should be involved in audit and quality improvement cycles, preferably using a ‘rapid cycle’ quality improvement approach. This approach benchmarks standards of care and may be an effective change driver. It is also an excellent way of providing evidence of good practice as defined by the GMC, and mapping the contribution that individuals make to any service within their...
