Scope of Service:

The Obstetrical Anesthesia Service provides around 1200 obstetric anesthetics each yearbut this experience is enriched because more than 50% of the patients belong to a defined high-risk group e.g., patients with severe pregnancy induced hypertension, heart disease (with NYHA classification IIIIV), asthma or aortic aneurysm.  Epidural analgesia services are available to all obstetric patients 24 hours a day, 7 day a week. All high risk patients will be seen by OB anesthesia team as soon as possible when they are admitted.  To better serve the high risk patients of our population base we will institute a special red label identification of all high risk patient charts and these will be sorted according to estimated due dates and thus be discussed as impending cases as the months report details. The OB anesthesia team is invited to join the Obstetric and Gynecologic Monday Case conference weekly to discuss interesting cases.

Quality Management:

1. Appointment of a qualified anesthesiologist to be responsible for all OB Anesthetics administered.

2. To ensure the safest and most effective anesthesia for obstetric patients, the director of OB Anesthesia Services, with the approval of the medical staff, must develop and enforce written policies regarding provision of obstetric anesthesia. _A special group of individuals suitably trained will serve as OB anesthesia faculty members._ It is the responsibility of the director of OB Anesthesia Services and the medical staff to review each individual's qualifications and competence and to determine which agents and techniques may be used.

3. The departmental QA Committee oversees the quality of OB anesthesia constantly. Identified QA problems will be reviewed by the committee. Suggestions to improve the quality of care will be given to the individual or through the education activities (e.g., grand rounds).