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Panel’s recommendations for safer cataract surgery in MA shared nationwide

A leading anesthesiology journal devoted its May 2018 cover and editorial to findings and recommendations for safer cataract surgery that stemmed from an initiative spearheaded by the Betsy Lehman Center in 2016.

Also published in this month’s Anesthesia and Analgesia were two peer-reviewed articles describing the work of an expert panel convened by the Center and charged with mining and disseminating lessons learned from a series of preventable adverse events that harmed Massachusetts patients undergoing cataract surgery in recent years.

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Removing cataracts is the most common surgical procedure performed nationally, as well as in Massachusetts. And while the vast majority of these surgeries are performed safely every year, a series of lapses – from patient misidentification to surgery on the wrong eye to anesthesia blocks that caused blindness – in 10 different surgery centers and hospitals in the state in 2014-2015 were reviewed by the expert panel.

Because the journal’s readers are practicing anesthesiologists across the country, coverage of the Betsy Lehman Center expert panel’s work in this month’s issue of Anesthesia and Analgesia emphasized the role anesthesiologists can play in lowering the risk of harm to patients – most of whom are elderly – during cataract procedures.

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A key recommendation of the Center’s expert panel was to urge cataract surgeons and anesthesiologists to use the “least invasive form of anesthesia appropriate to the patient” with an aim of increasing the use of topical drops to anesthetize the eye during surgery when warranted, rather than techniques that deliver anesthesia to the eye with a needle. 

"We are pleased to see the work done by our expert panel available to an even larger group of practitioners," says Barbara Fain, Executive Director of the Betsy Lehman Center. 

Equally important, Fain notes, was the panel's use of adverse event data reported by individual facilities as required by Massachusetts law to share lessons learned from the events more broadly.

"We have heard from members of the provider community that they'd like to see adverse event reports be used for shared learning," she adds. 

Fain expressed gratitude to the Center's partners on the project and the expert panel members. She added a special thanks to co-chair and article author Karen C. Nanji, MD, for bringing this work to the attention of anesthesiologists in Massachusetts and across the country.

Partners on the project included: the Massachusetts Association of Eye Physicians and Surgeons, the Massachusetts Society of Anesthesiologists, the Massachusetts Department of Public Health and the Quality and Patient Safety Division of the state's Board of Registration in Medicine.

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