[Registration of problems during anesthesia. Analysis of risk factors and quality control]

Society continues to increase its demands on the medical profession in regard to quality. We believe this situation should be met by a more systematic approach to risk evaluation and quality assessment of our work. We report an attempt to establish a routine system for recording complications during anesthesia. We included all 14,735 patients who were anesthetized during one year. Data on preoperative disease, type of anesthesia and operation, and problems encountered during anesthesia were recorded on the routine anesthesia chart. An arbitrary scale from 1-3 indicated the severity of the problem. Postoperatively, data from each patient were fed into a personal computer. The system is feasible in a busy clinical setting. Key problems are work discipline, exact criteria for complications, and quality control of anesthesia charts. 655 problems were recorded in 599 patients. 80 problems were very serious. Problems such as drop in blood pressure, intubation, laryngeal spasm and cardiac arrhythmias dominated. Such registration increases awareness for the safety of the patients, and enables us to assess the risk and evaluate the quality of our work. The system is now an integral part of the department's routine.