Airway Culture - UK Airway Lead Concept -Alistair McNarry (Edinburgh)

Society For Airway Management 2016

"any process that is measured will improve"

Medical education and practice culture .

 1. The tools available for  airway management continue to improve annually and have now reached a stage of development that permits excellence in care of normal and difficult airways.

2. The Human Factors and Culture have become the critical area for improvement. If one has a plan that includes available tools, a knowledge of the patient variables, skill in selecting and applying the tools should virtually always produce a desirable result.

3. There remains a disturbing variation in the availability of equipment and skill applied in various hospitals and regions.

4. As the understanding of our art improves it is imperative that we develop a more orderly way of applying it.

The UK "Airway Lead" Concept.

The development of a systems approach in the UK is very instructive. The recognition of serious problems in difficult airway management resulted in assembly of a highly motivated team of investigators who produced a National study document - NAP4- which investigated the scope of unfortunate events and propelled changes. This ultimately was distilled into the  

Difficult Airway Society 2015 guidelines for

management of unanticipated difficult intubation

in adults.     

 British Journal of Anaesthesia, 115 (6): 827–48 (2015)

       The Problem: How to propel the change into the entire NHS System?

The "National Airway Lead"- Alistair McNarry

To organize the knowledge rollout a National Airway Lead was appointed with a goal of developing local Hospital Airway Leads whose mission is to :

1. Identify and master the changes that are evolving.

2. Identify the essential tools to make excellence possible.

3. Develop a local airway culture.

4. Measure and adapt local results.

The British example is extremely well conceived and in my view should be embraced to produce  a culture of excellence proven by measurement. Haphazard approaches will not produce the kind of changes that we need.

As my Engineering friends remind me: 

"any process that is measured will improve"