For Bana Jamil, being an Anesthesia Assistant (AA) at North York General Hospital (NYGH) is the fulfillment of an opportunity she realized long ago to improve patient care and reduce wait times. Jamil is one of four new AAs hired at the hospital as part of the second phase of the provincial government’s Anesthesia Care Team (ACT) project.
In an ACT, AAs work under the direct supervision of an Anesthesiologist to supply technical and operational support. AAs are respiratory therapists (RTs) with specialized training to provide operative and anesthesia services, or registered nurses with advanced preparation at a Masters level who assist with pre- and post-operative anesthesia care.
Currently, three schools in Ontario offer an AA Graduate Certificate for RTs. The Faculties of Nursing and Medicine at the University of Toronto have established a Nurse Practitioner-Anesthesia program which provides the training required for nurses to participate in ACTs.
Even before she decided to obtain additional training as an AA, Jamil “noticed a great opportunity for increased RT involvement in the operating room. When the AA role was initiated, I realized how much more could be accomplished with these sorts of additional resources,” she says. “Now in this second phase of the ACT program, we, as a larger group of AAs are going to be able to help improve patient flow through the operating room and provide quicker access to care in areas such as obstetrics.”
ACTs grew out of recommendations made by the joint Ontario Ministry of Health and Long-Term Care and Ontario Medical Association Operative Anesthesia Committee (OAC) in 2006. The initial success of the ACT pilot project led over 60 hospitals to apply for funding in this second phase, and North York General Hospital was one of only 13 sites chosen. The other sites include: Kingston General Hospital, Lakeridge Health Corporation, Mount Sinai Hospital, North Bay General Hospital, Quinte Health Centre, St. Joseph’s Healthcare (Hamilton), St. Joseph’s Health Centre (Toronto), St. Michael’s Hospital, Sunnybrook Health Sciences Centre, The Hospital for Sick Children, The Ottawa Hospital, and William Osler Health Centre.
The four AAs at NYGH will assist the Department of Anesthesia in the areas of paediatric surgery, orthopaedic surgery, emergency surgery and labour and delivery.
“Providing patients and their families with safe, high quality, compassionate care is a priority at North York General Hospital and Anesthesia Care Teams will contribute to this goal,” says Dr. Stephen Brown, NYGH Chief of Anesthesia and Past-Chair of the Ontario Medical Association Section on Anesthesiology. “In addition, Anesthesia Assistants are an important step towards addressing the shortage of Anesthesiologists in Ontario, and maximizing the skills and experience of trained professionals to provide greater surgical support.”
The second phase of the ACT project will run until 2011. They will be evaluated based on three key criteria: clinical efficiencies and quality of care, patient safety and patient and staff satisfaction. The evaluation process will consist of collecting prospective and retrospective data from each participating site and, where appropriate, comparing the outcomes of patients treated by an ACT to a similar patient treated without an ACT.
Jamil hopes that ultimately the result will be more Anesthesia Assistants trained in Ontario and Anesthesia Care Teams becoming a permanent part of the Ontario health-care system.