Anesthesia Patient Safety Podcast

#282 Building Safer Anesthesia Teams In A Locum-Driven World

Ever walked into a new OR and spent the first ten minutes hunting for an airway bougie or a computer log-in that actually works? We dig into the hidden safety risks of a transient anesthesia workforce and share practical, fast-moving fixes that keep patients safe while keeping rooms open. With staffing shortages reshaping coverage models across the United States and beyond, locum clinicians are essential—but inconsistent environments, unclear escalation paths, and fragmented communication can turn small friction points into big hazards. We unpack what the current evidence says—and doesn’t—about locum-related outcomes. A UK qualitative study surfaces predictable threats like unfamiliar systems and weak team integration, while primary care data shows prescribing differences without higher adverse events. In anesthesia, large safety studies are scarce, so leaders must rely on smart design: targeted orientation, standardized room setups, and shared mental models that don’t depend on who’s on the schedule. We also talk dollars and sense, highlighting a simulation-based break-even estimate for when full-time hiring outperforms locum coverage, and how to weigh cost without compromising safety. From the main OR to higher-risk non-operating room anesthesia sites, we outline concrete steps that work across settings. Limit initial deployment to oriented locations, add locum staff to all communication channels from day one, and use checklists, cognitive aids, and universal timeouts to reduce variability. Establish clear role definitions and escalation trees posted in every anesthetizing location, and fold temporary clinicians into audits, feedback loops, and ongoing education. The aim is simple: compress the ramp-up, eliminate guesswork, and make the safe action the easy action—even when teams change daily. If you care about perioperative safety, access, and team resilience, this conversation gives you a playbook to act now. Subscribe, share with a colleague who onboards locums, and email your best orientation tip so we can feature it on a future show. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/282-building-safer-anesthesia-teams-in-a-locum-driven-world/ [https://www.apsf.org/podcast/282-building-safer-anesthesia-teams-in-a-locum-driven-world/] © 2025, The Anesthesia Patient Safety Foundation

#281 Safer Anesthesia, Everywhere

Imagine stepping into an operating room where oxygen isn’t guaranteed, capnography is rare, and one anesthesiologist might serve a million people. That’s the reality many patients face, and it’s exactly where meaningful change can save the most lives. We sit down with Dr. Kelly McQueen, professor of anesthesiology and department chair at the University of Wisconsin, to explore what it takes to deliver safe anesthesia in low and middle-income countries and how practical solutions—rooted in training, equipment reliability, and data—can close the gap. We trace how safety became foundational in anesthesiology in high-resource settings while many colleagues abroad still rely on vigilant listening and teamwork to compensate for missing monitors and essential medicines. Dr. McQueen explains the workforce crisis—too few trained providers, concerns with credentialing, limited continuing education—and why the fix starts with lifting current teams, not replacing them. We discuss how ministries of health, medical schools, and national anesthesia societies can drive lasting change by investing in local training pipelines, fair compensation, and clear standards that elevate both physician and non-physician providers. From the WHO Surgical Safety Checklist to Lifebox-style initiatives, we look at how checklists adapted to local constraints can improve outcomes when paired with reliable oxygen, pulse oximetry, and capnography. We also dive into the power of perioperative mortality reviews which can turn scarce data into quality improvement that sticks. Dr. McQueen makes a compelling case for bilateral partnerships that build capability, confidence, and leadership so anesthesiologists can advocate for what their patients need most. If you care about global health equity, safer surgery, and the systems that truly protect patients, this conversation brings clarity and momentum. Listen, share with a colleague, and subscribe so you don’t miss future episodes—and leave a review to help others find the show. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/281-safer-anesthesia-everywhere/ [https://www.apsf.org/podcast/281-safer-anesthesia-everywhere/] © 2025, The Anesthesia Patient Safety Foundation

#280 Speak Up To Save Lives

What if the biggest risks in maternal care are not just clinical, but cultural? We dig into the hard truth that speaking up can feel risky, pain during cesarean is often underestimated, and rare obstetric crises can overwhelm memory. From there, we chart a path toward safer births with practical tools that any team can use: psychological safety to unlock communication, structured pre‑briefs and rapid debriefs, and cognitive aids that turn chaos into coordinated action. We walk through the lived reality of intraoperative pain—why negative skin tests don’t guarantee visceral coverage, how fear of general anesthesia can delay needed care, and the downstream consequences for bonding, breastfeeding, and mental health. You’ll hear clear, patient‑centered steps: standard sensory assessment, explicit pain check‑ins, decisive treatment or conversion when indicated, and honest conversations that validate experience. The message is simple and urgent: pain is preventable harm, and timely action saves more than minutes—it protects families. Readiness matters beyond big hospitals. Rural teams face OB unit closures, low volumes, and limited resources. Mobile simulation and statewide programs show how to keep skills sharp for postpartum hemorrhage, eclampsia, and high‑risk transfers. We also highlight the Four Ps for anesthesia professionals—presence, preemption, proficiency, and platform—to embed safety into daily practice, from risk screening to standardized pathways. Finally, we extend the safety net into the community with sepsis bundles and accessible education so patients and their support networks recognize warning signs and act fast. Along the way, we touch on pediatric safety and emerging evidence that EEG‑guided anesthesia can reduce emergence delirium. If transforming maternal care speaks to you, join us. Subscribe, share this episode with a colleague, and leave a review with one change your team will make this month. Your insight could be the spark another unit needs to save a life. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/280-speak-up-to-save-lives/ [https://www.apsf.org/podcast/280-speak-up-to-save-lives/] © 2025, The Anesthesia Patient Safety Foundation

#279 From Birthrooms To Boardrooms: Preventing Trauma And Elevating Maternal Anesthesia Care

Power, control, and communication shape every birth—and too often, they decide whether care feels safe or traumatic. We dig into practical ways to prevent harm in obstetric anesthesia by centering trauma-informed care, reducing stigma around substance use disorder, and giving real choice during cesarean delivery. We start by distinguishing complications from trauma and laying out the six pillars that make care safer: safety, transparency, peer support, collaboration, empowerment, and cultural humility. From there, we map prevention across three levels—primary disruption of trauma through clear communication and environment, secondary recognition and mitigation of events, and tertiary support for patients with PTSD. You’ll hear concrete steps for SUD in pregnancy, including continuing methadone or buprenorphine, optimizing regional anesthesia, avoiding medication switches, and using person-first language that builds trust rather than barriers. We also spotlight the Elevate project, which advances patient-centered anesthesia choices for cesarean delivery through stakeholder engagement, research, and an in-person summit focused on equity and shared decision-making. The aim is simple and vital: align what clinicians must do with what patients most value, from how we speak at the drape to who is present in the room. Finally, we share life-saving resources from the AFE Foundation—education, an international registry, and a stabilization checklist—to turn rare crises into moments of coordinated, effective response. If these ideas resonate, share this episode with a colleague, subscribe on your favorite platform, and leave a review with one change you plan to make on your next shift. Your feedback helps more clinicians find these tools and deliver safer, more humane maternal anesthesia care. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/279-from-birthrooms-to-boardrooms-preventing-trauma-and-elevating-maternal-anesthesia-care/ [https://www.apsf.org/podcast/279-from-birthrooms-to-boardrooms-preventing-trauma-and-elevating-maternal-anesthesia-care/] © 2025, The Anesthesia Patient Safety Foundation

#278 Transforming Maternal Care Through Equity, Science, And Tech

Maternal care is at a breaking point: delivering hospitals are disappearing while deaths that could be prevented keep climbing. We pull back the curtain on how structural racism, policy headwinds, and technology blind spots compound risk for birthing people—especially Black, Hispanic, rural, and low‑income patients—and what it takes to change the trajectory now. We start by naming the problem with data: stable birth rates alongside a steep decline in maternity units have created care deserts. From there, we dig into disparities in obstetric anesthesia, including lower neuraxial labor analgesia use and higher rates of general anesthesia for cesarean delivery among Black and Hispanic patients. Drawing on ASA recommendations, we outline practical actions that reduce harm: accurate documentation of race, ethnicity, and language; disparities dashboards; education on bias and structural racism; shared decision making; and proactive epidural management to improve conversion to surgical anesthesia without general anesthesia. Then we turn to implementation science—the missing link between guidelines and reliable practice. We map a simple decision pathway from efficacy to effectiveness to context and strategy, and we share the real levers that move systems: targeted education, inter‑institutional collaboration, policy mechanisms like bundles, and the business case that earns C‑suite commitment. When leaders see the return on investment in safety, liability reduction, and community trust, sustained resources follow. Finally, we explore technology as an equity engine. AI‑guided ultrasound can extend expertise in low‑resource settings. Predictive analytics may flag fetal heart rate decelerations before they turn critical. And we confront the accuracy gaps in pulse oximetry tied to skin pigmentation and low perfusion, especially during the neonatal transition. With vendor accountability, rigorous validation across diverse populations, smarter sensor selection and placement, and frontline education, monitoring can serve every patient equally. If this conversation resonates, help us spread the word. Subscribe on Spotify or YouTube, share this episode with a colleague, and leave a review so more clinicians can join the effort to make labor and delivery the safest unit in the hospital. Your feedback and stories shape where we go next. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/278-transforming-maternal-care-through-equity-science-and-tech/ [https://www.apsf.org/podcast/278-transforming-maternal-care-through-equity-science-and-tech/] © 2025, The Anesthesia Patient Safety Foundation