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Doody's Review ServiceReviewer: Philip D. Ogden, MD (University of Chicago Pritzker School of Medicine)
Description: This small paperback volume explains the necessity of quality assurance in the anesthesia department and gives general guidelines on creating a systematic total quality management (TQM) program.
Purpose: The authors intend to show how review of a department's practice by its own members, and subsequent changes in that practice, can be made for the benefit of patients' safety. This concept of TQM, common in industry, is being applied more and more often in medicine, and, as the authors demonstrate, also helps in resource management (i.e., cost reduction) as well as quality improvement.
Audience: The book is written for practicing anesthesiologists who are faced with the challenge of instituting a departmental program of quality assurance, particularly within the U.K. according to the dictates of the National Health Service. Nevertheless, the philosophy of TQM and many of the author's guidelines are easily adaptable to U.S. departments and training programs.
Features: The book consists of 11 self-contained chapters, but can easily be read in its entirety in one sitting. Illustrations are few, consisting mainly of simple diagrams and tables. Several boxes set apart from the text emphasize certain highlights within each chapter. References are current, but the subject of quality management in anesthesia was scarcely addressed in medical literature prior to the last 10 years. Information being generated now and in the near future may eclipse many of the references here.
Assessment: Total quality management in medicine is in its infancy, but is perhaps most easily adaptable to departments of anesthesia because of a history of specialty-wide standards in equipment and recordkeeping, in addition to standards of training (board certification) found in all specialties. The book is short on the philosophy of TQM, but that subject is more adequately covered elsewhere, though usually in business literature. It is also short on details of quality management in anesthesia, particularly outside the U.K., but there is little experience to draw upon at this time. Economic and political forces are rapidly changing that.