Ethical, Legal, Practical and Scientific Challenges in Perioperative Medicine
Cost-effective, safe, timely, and socially responsible are the watchwords of accountable, outcome-dependent twenty-first century medical care and its delivery. Requisite physician and allied professional behavioral changes necessary to accommodate new performance standards are most noted in the acute interventional and perioperative specialties because immediacy is associated not only with advanced technology, but also with obvious outcome accountability. Anaesthesiologists, critical care physicians and surgeons are equally accountable in the new paradigm, and the likely direction of change may be predicted in the new publication from the Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century. This is the sequel to the report To Err is Human published in November 1999, and it focuses attention in different but equally difficult areas to change. William Richardson, (President W.K. Kellogg Foundation and Chair, Committee on Health Care in America) preceded the introduction of the report with a widely publicised opening statement and executive summary. He prefaced his remarks noting the “U.S. health care system is in need of fundamental change. Americans ought to be able to count on receiving care that is safe and uses the best scientific knowledge. But there is strong evidence that this is not the case. Health care today harms too frequently, and fails to deliver its potential benefits routinely. ... Between the care we have and the care we could have lies not just a gap, but a wide chasm” .
KeywordsAbdominal Aortic Aneurysm Noncardiac Surgery Scientific Challenge Critical Care Physician Information System Architecture
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