Harris Talks is a thought leadership series where our faculty experts tackle pressing
questions on current health care topics. Associate Professor of Professional Practice
Casey Crow, DNP, CRNA, explains how collaboration between health care professionals, including
Certified Registered Nurse Anesthetists (CRNAs), and patient advocates plays a vital
role in ensuring personalized, safe and effective care that improves patient outcomes.
Can you discuss the collaborative efforts between health care professionals and patient advocates in improving health care outcomes?
The role of certified registered nurse anesthetist (CRNA) carries a huge responsibility in collaboration between health care professionals. When we care for patients, we must focus on the patient as a whole. It's easy for specialized disciplines in medicine to focus on the individual needs of the patient.
For example, a surgeon focuses on surgical interventions, an endocrinologist may focus on diabetes care and a cardiologist focuses on the treatment for cardiac conditions. All these specialties are valuable and necessary. This illustration exemplifies that each patient presents with different, and frequently multiple, medical conditions, home medication lists, laboratory values, etc.
When the patient presents for surgery, it is often the anesthesia team who collaborates with all disciplines, directly or indirectly at times, to ensure that the patient is optimized for anesthesia and surgical care.
This collaborative effort also applies outside of anesthesia practice. A bedside registered nurse (RN) is often pulling-together multiple disciplines in the hospital setting. The RN is responsible for communicating with several physicians ensuring collaboration of care instead of segmented care. Additionally, it is the RN who is frequently the familiar voice when providing information to the family. Health care outcomes are improved when the patient is viewed as a whole.
What are the key principles in ensuring quality and safety in anesthesia interventions and patient care?
It is of utmost importance to consider and recognize that each patient is unique. Each patient has different backgrounds and needs with multiple medical disciplines involved in their care. This requires collaboration amongst medical specialties.
One of the Code of Ethics established by the American Association of Nurse Anesthesiology (AANA), addresses the CRNA’s professional responsibility of clinical practice and the interdisciplinary team. That includes respecting and engaging health care providers to foster a collaborative and cooperate patient care environment through a culture of safety and open communication to contribute to the ethical and safe environment of care.
To ensure quality, anesthesia providers must continue to stay up to date with the most current research findings and practice guidelines. This is done by gathering research literature then evaluate the outcomes and recommendations of research. Focusing on implementing best-known practices results in improvement of health care practice and patient outcomes.
Can you discuss the importance of tailoring anesthesia interventions to meet the unique needs of each patient?
No patient is the same and therefore cannot be treated the same. When creating an anesthetic plan, the patient is at the center. This is the most effective way to ensure that anesthesia interventions are appropriate and safe.
It is the consideration of a physical exam, medical history, social history, home medications, laboratory results and anesthetic requirements for surgery that is involved in the planning of an anesthetic plan. It is purposefully thorough and specific.
Additionally, one plan will not suffice. I like to tell my patients, “In anesthesia, we have plans A through Z. We will do whatever keeps you the safest.” I tell this to my patients after discussing their primary anesthetic plan. This reinforces patient safety as the pinnacle of anesthesia practice, as evidenced by individualized patient planning and preparedness.