The Department of Anesthesia and Perioperative Medicine continues to build on the success of the Anesthesia Care Team. We have continued with the development of this program. The two major teaching hospitals in London, London Health Sciences Centre and St. Joseph’s Health Care London, and the Department of Anesthesia and Perioperative Medicine have invested more resources into this program to increase the number of Anesthesia Assistants, and increase the number of areas the department can integrate care.
Anesthesia Assistants have been integrated in to work routines and clinical care with the cooperation of the entire Department. This has allowed us to reliably provide service for some of the key wait time initiatives such as cataract surgery. In the cataract suite we use a model of care where one consultant supervises two Anesthesia Assistants.
Other AA’s assist in the block room or monitor patients after major regional blockade or provide special assistance in the operating room for more complex cases. Care of patients outside the OR such as pediatric imaging and procedures, neuroradiology or electrophysiology labs have all benefited from having consistent, reliable assistance in these challenging environments.
In September 2008, Fanshawe College in London initiated a training program for Anesthesia Assistants. The Department of Anesthesia and Perioperative Medicine, Schulich School of Medicine & Dentistry, has been involved in the design of this program, and has provided a significant amount of classroom and operating room instruction.
During the Basic Program, run from September to December, most teaching is provided by Fanshawe College instructors affiliated with the long–established Respiratory Therapy Department. For the Advanced Program or second semester which runs from January to April most of the lectures and workshops are physician directed. Many of the senior anesthesia residents participate in teaching these courses and workshops. Residents and the participating faculty members found this to be a rewarding training experience. Enrollment has begun for next year’s class.
Nationally there is new competency framework for anesthesia assistant teaching. This year we have introduced a new curriculum with the goal of improving this teaching framework. Fanshawe College has been at the forefront of this evolution. The Fanshawe teaching program will be reviewed under a new national accreditation program this year.
The role of Anesthesia Assistants is generally becoming widespread in Ontario and Canada and has been recently adopted by the Canadian Anesthesiologists’ Society. Currently, we are developing new models of care in areas where previously, the Department has not had the human resources to provide coverage. This includes endoscopy and obstetrics with expanded invasive radiology.
We have participated in provincial teams in association with the MOHLTC to further develop and define the roles within the Anesthesia Care Team. Review of the application of the ACT model has demonstrated a cost effective, safe and accepted model of care. We have continued to receive funding from the Ministry of Health that continues to support the ACT program.
We will continue to explore ways to improve patient safety, efficiency and improve the working conditions for anesthesiologists.