Special Perioperative Considerations in Anesthesiology

Anesthesia providers are faced with increasing work stressors and challenges that affect both patient care and the health of providers. Most physicians cope with stressors by relying on situational and personal characteristics. Addiction remains a relatively common maladaptive response. Anesthesiologists tend to abuse more potent medications than the general population and have a higher mortality rate than other practitioners with substance use disorder. Distractions from personal stressors, combined with a myriad of distractions in the operating room, can jeopardize vigilant practice. How can we better provide for the safety of our patients and satisfaction within our own lives? 1) Mindful practice can lead to an internal state of personal wellness. 2) Intentional design of clinical processes can simplify our workflows and increase resilience to errors. 3) Adoption of performance improvement techniques and error reduction strategies can focus on identifying deviations from practice. 4) Checklists and standardized workflows, along with structured communication and team training can improve shared understanding and the reliability of our work. Adoption of such interventions can reduce the burden of our work and improve outcomes for both the practitioner and the patient. This review contains 2 figures, 6 tables, and 55 references. Keywords: burnout, disclosure of mistakes, distractions, malpractice, mindfulness, performance improvement, physician impairment, safety, substance use disorder