Starting October 1st, the Centers for Medicare & Medicaid Services (CMS) initiates rules that limit claims for 10 hospital-acquired, in-patient conditions. According to a CMS press release, this is an aggressive move to encourage greater patient safety and to reduce the number of "never events" - preventable medical errors that result in serious consequences for the patient. These never events also result in additional costs to Medicare and Medicaid in order to treat the consequences of the errors. CMS sees this as a reflection of a strong commitment that these events should be prevented. AMA delegates feel that the conditions on the list are not always preventable, even if evidence-based guidelines are followed.

Some of the conditions on the no-pay list are directly related to patient care that occurs in the operating room. AAs should familiarize themselves with this list that includes vascular catheter-associated infection, foreign object obtained after surgery, blood incompatibility, and certain manifestations of poor blood sugar control. Most facilities or departments of anesthesiology have protocols or policies and procedures for checking blood prior to its administration to a patient, blood glucose monitoring, and sterile technique for insertion of various in-dwelling catheters. AAs should seek out these policies and protocols to be sure that they are in compliance. If these policies and protocols do not reflect the most current study-based recommendations, then AAs should be pro-active in bringing this to the attention of the appropriate person or committee.

Recently reported lapses in proper drug administration techniques have resulted in needless and preventable transmission of infectious disease during anesthetic care. This is highly regrettable and unacceptable professional conduct. As professionals dedicated to the provision of safe anesthesia care, we take this opportunity to emphasize our commitment to optimal patient safety and to speak out regarding the importance of infection control procedures.

Not only do we do not condone unsafe infection control practices, but we adhere to standards requiring the highest level of care in infectious disease prevention (http://www.asahq.org/publicationsAndServices/infectioncontrol.pdf). Together, we recognize that everyone involved in patient care needs to be well educated in the control and prevention of infectious disease, as well as, the strict adherence to all infection control practices.

Professionals who cut corners in healthcare services, risk not only the health of their patients, but the credibility of their profession - a profession where the guiding adage is "Do no harm." To do any less undermines the sacred trust that we have been given as healthcare practitioners. It is every healthcare provider's responsibility to serve as a guardian for every patient to whom they provide care.

Each of our organizations are united against poor infectious disease control practices. We invite all health care professionals to take a stand with us and adopt stringent infectious control standards and create an open forum for making infectious disease control a top priority in all healthcare settings.

Together in care,

Jeffrey L. Apfelbaum, M.D.
President
American Society of Anesthesiologists

Deborah A. Lawson, AA-C
President
American Academy of Anesthesiologist Assistants