Patient Safety & Leadership

Airway management leadership

Airway management is at the centre of anaesthetic safety. For more than a decade I have been involved in the bodies that guide airway practice across Australia and New Zealand.

• State Airway Lead, Victoria and TasmaniaANZCA · 2016–2023
• Chair, ANZCA Airway Management Working GroupANZCA · 2014–2016
• Executive, Airway Management Special Interest GroupANZCA, ASA and NZSA · 2014–2021
• Chair, Airway Management Special Interest GroupANZCA, ASA and NZSA · 2011–2014
• SWAPNet Advisory GroupQueensland Government State-wide Difficult Airway Alert · 2018–2021

Professional standards

ANZCA professional documents set the standards that anaesthetists across Australia and New Zealand work to. I have led or contributed to the development of the following:

Operating room fires are uncommon, but they continue to be reported and can cause serious harm. The guidance helps theatre teams reduce the risk by using only the oxygen a patient needs, limiting fuel such as alcohol-based skin preparations, and managing ignition sources such as diathermy and lasers.

Guidance and educational resources

• ANZCA Airway Assessment resourceCo-author and editor · Airway Management Group, 2016
• Transition from supraglottic to infraglottic rescue in the CICO scenarioANZCA Airway Management Working Group Report · Chair of the working group, 2014
• ANZCA CICO CPD Emergency Response ActivityReviewer and developer · 2014
• Topicalisation and sedation for awake fibreoptic intubationLead developer of a free educational iPad app (2011), downloaded more than 1,500 times; published in 2012 as a downloadable resource for Anaesthesia Continuing Education (ANZCA, ASA and NZSA)

Clinical governance

Good governance means learning from incidents and near misses, and making sure that learning reaches the people and systems that need it.

• Victorian Perioperative Consultative CouncilSafer Care Victoria · Executive Anaesthetic Subcommittee · 2021–presentThe council oversees, reviews and monitors perioperative care in Victoria.
• Epworth Anaesthetic Advisory CommitteeEpworth HealthCare · 2013–2025Risk management, root cause analysis of critical incidents and safety initiatives.
• webAIRS CoordinatorEpworth HealthCare · 2013–2025Coordinating the web-based anaesthetic incident reporting system of the Australian and New Zealand Tripartite Anaesthetic Data Committee (ANZTADC).
• Chair, VMO Morbidity and Mortality GroupThe Alfred, Department of Anaesthesia and Perioperative Medicine · 2008–2011
• Critical incident review and medicolegal assessmentOngoing experience in reviewing critical incidents and providing medicolegal assessments

Quality improvement

The Epworth Difficult Airway Trolley Project

In 2014 I led the development of a standardised difficult airway trolley for Epworth HealthCare, designed using human factors principles so that equipment is laid out logically and can be found quickly in an emergency. It was rolled out across all Epworth sites and was subsequently used in the St Vincent's Private network and by Ramsay Health. Other services across Australia and New Zealand have since adapted the design.

The project was presented at the World Airway Management Meeting in Dublin in 2015 and described in the ANZCA Bulletin, and the wider principles of trolley design were the subject of an editorial in Anaesthesia.

State-wide difficult airway alerts

From 2018 to 2021 I was an advisor to SWAPNet, the advisory group for the Queensland Government's State-wide Difficult Airway Alert. Alerts of this kind help make sure that when a patient is known to have a difficult airway, the teams caring for them in future are aware of it.

Expert review

• EMAC Airway Emergencies: A Human Factors Approach, ANZCA, 2018
• Airway curriculum component of the ANZCA Registrars Training Program, 2013
• Peer reviewer for the British Journal of Anaesthesia (from 2014) and Critical Care and Resuscitation (2013)