Anesthesia Incident Reporting System
Report events at www.aqiairs.org
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The Anesthesia Quality Institute (AQI) created the first nationwide system for collecting individual adverse events from anesthesia, pain management and perioperative care. AIRS is an online reporting tool to enable physician anesthesiologists to learn from the experience of their colleagues. AQI reports are used to educate about how to reduce or prevent future similar events.
AQI encourages reporting from any individual anesthesia provider who encounters a situation in which an unintended event related to anesthesia or pain management with the significant potential for patient harm occurred while a patient was under care. Some examples of this include:
Unusual reaction to anesthetic medication
Unusual manifestation of patient disease/surgery
Challenging diagnostic situation
Novel or unexpected system failure
AIRS currently has 4 specialty modules, with more on the way:
Respiratory depression – Cases that involved a respiratory depression event.
Drug shortage – Cases that involved a lack of necessary medications.
Obstetrics – Cases that fall under the OB/GYN procedural service type or took place in an institution’s OB ward.
Pediatrics – Cases for patients under the age of 18.
All AIRS reports are made over a secure encrypted Internet connection and are maintained in strict confidence (and firewall isolation) on the AQI server.
Reports can be made either anonymously (no record of sender) or confidentially (sender contact information retained). Confidential reporting allows the reporter to modify an initial report with follow-up information; it also allows AQI to contact the reporter to elucidate important or ambiguous details.
Legal protection is conferred by AQI’s standing as a Patient Safety Organization (PSO). Federal law protects any “patient safety work product” from legal discovery and in fact imposes strict guidelines on the way in which the PSO must preserve the confidentiality of its work.
Per these regulations, the AQI will NEVER reveal the identity of any patient, provider, facility or practice gathered through AIRS.
AIRS data is abstracted by a committee of physicians who help publish interesting cases which appear each month in the ASA Newsletter. The AIRS Committee will also periodically examine the entirety of AIRS for emerging trends in anesthesia patent safety.
Full text article about AIRS in the October 2011 issue of the ASA Newsletter (PDF)
Anesthesia Incident Reporting System (AIRS) (PPT) About AIRS
Slides on AIRS Event Reporting: Theory & Practice (PPT)
Anesthesia Patient Safety Foundation (APSF) 2010 Medication Safety Conference Report (PDF)
Complimentary magnets & decals (sample below) to post at your facilities are available by emailing Ashley Kieta. Please specify quantities and mailing address.
A word cloud generated from the most common words found in cases submitted to AIRS.
Stanford Emergency Manuals:Cognitive Aids for Perioperative Critical Events
EMIC (Emergency Manuals Implementation Collaborative) - Find links to many free tools & resources.
Brief video for local leaders and champions:Why and how to implement emergency manuals at your institution