Organisation of Anaesthesia Services: Peer Review
Clinical governance is defined as a system through which health services are responsible and accountable for: continuously improving services, safeguarding high standards of care, and ensuring the best clinical outcomes for patient care. The system of governance includes the following aspects of clinical risk management: Mortality and morbidity reviews. Adverse events and near-misses reporting an
Clinical governance is defined as a system through which health services are responsible and accountable for:
- continuously improving services,
- safeguarding high standards of care, and
- ensuring the best clinical outcomes for patient care.
The system of governance includes the following aspects of clinical risk management:
- Mortality and morbidity reviews.
- Adverse events and near-misses reporting and reviews.
- Patient record reviews and peer reviews.
- Clinical audits on various aspects of anaesthesia processes in various anaesthesia practices, measuring compliance with best practice.
Peer review is a voluntary process and a function of SASA’s Regulation Business Unit. SASA has a comprehensive peer review policy and procedures that have been established to manage such requirements. Queries can be sent to sasa@sasaweb.com.
Please refer to the 2020 published peer review policy and procedure (Appendix A [Peer review document])
The SA DoH’s new policy on patient safety incident reporting for all adverse events is available in Appendix A (Safety incident reporting and learning).
An adverse event can be defined as harm, an injury or complication associated with medical treatment. This may or may not be because of error. A near-miss is a possible injurious event that is intercepted before it reaches the patient.
Errors can be categorised as serious or minor and may be because of a mistake by a doctor, another health team member or a systems error.
When documenting events around a medical error, the documentation must be factual and exhaustive. It is essential to avoid speculation regarding cause or blame.
Should a death occur, The Health Professions Amendment Act of 2007 states the following:
“Death of a person undergoing a procedure of therapeutic, diagnostic, or palliative nature or of which any aspect of such a procedure has been a contributory cause, shall not be deemed to be a death from natural causes as contemplated in the Inquests Act, 1959 (Act 58 of 1959), or the Births, Marriages, and Deaths Registration Act, 1963 (Act 81 of 1963).”
This means that all doctors and nurses who work in operating theatres must be made aware of the law, and that all unnatural (perioperative) deaths must be reported, regardless of the sentiments of the medical team and/or the next of kin.
This same group of medical personnel needs to be instructed to the effect that all unnatural deaths must be reported, regardless of the length of time that has elapsed since the administration of the anaesthesia. Documents regarding the report are discussed in the Records section of these guidelines.
It is strongly advised that one’s indemnity insurance company should be notified immediately, particularly in cases where the death has been sudden and unanticipated.
South African Society of Anaesthesiologists (SASA) Practice Guidelines_2022_Reviewed by: N Zimmelman