Differences in anaesthesiologist-surgeon seniority and patient safety: a single-centre mixed-methods study

Area of Science:

• Medical Research
• Patient Safety Studies
• Healthcare Management

Background:

• Junior anaesthesiologists may struggle to gain surgeon trust due to inexperience.
• Disagreements between junior anaesthesiologists and senior surgeons can create pressure.
• Investigating the impact of anaesthesiologist-surgeon seniority differences on patient safety is crucial.

Purpose of the Study:

• To determine if differences in anaesthesiologist-surgeon seniority affect patient safety.
• To explore how these seniority differences influence clinical decision-making and potential disagreements.

Main Methods:

• A sequential explanatory, mixed-methods design was employed.
• Quantitative phase: Retrospective case-control study of anaesthesia-related adverse events.
• Qualitative phase: Semi-structured interviews with attending anaesthesiologists using grounded theory.

Main Results:

• No significant association found between anaesthesiologist-surgeon seniority differences and adverse events (aOR 1.00, P=0.634).
• Anaesthesiologists prioritized patient safety during disagreements, regardless of seniority.
• Junior anaesthesiologists encountered challenges but received peer support.

Conclusions:

• Anaesthesiologist seniority relative to surgeons does not significantly impact their ability to ensure patient safety.
• Clinical decisions in disagreements are primarily driven by patient safety concerns.
• Team support within anaesthesiology is vital for junior practitioners.