Background: Anesthesia drug shortages are increasingly common. However there is little information on the qualitative experience of anesthesiologists providing clinical care in the face of repeated drug shortages. This interview study of pediatric anesthesiologists working at a high-volume children's' hospital sought to examine how clinicians perceive the impact of drug shortages on their work.
Methods: Using a semi-structured series of questions, pediatric anesthesiologists were interviewed regarding the impact of drug shortages on their clinical work. Interviews are coded and analyzed as the data is being generated, incorporating methods from grounded theory, as described by Strauss and Corbin (1990). This method utilizes a combination of inductive and deductive approaches to analyzing data and involves an iterative, conjunctive process of reviewing interviews. It identifies emerging themes within qualitative text data and develops theories about the phenomenon described by these themes, sampling until new data no longer change the developed theory (saturation). All members of the research team code each interview. Divergent coding is reviewed and discussed by the group until consensus is reached. After completing the coding, we discuss the themes that emerge. Using an iterative approach, comprehensive themes and the specification of relationships among these themes are developed.
Results: Preliminary results suggest several emerging themes including "What is the appropriate level of information that is still considered informed consent?” “Who is responsible for managing drug shortages/allocations of resources?”
Conclusions: While research is still ongoing, preliminary data suggests pediatric anesthesiologists feel obligated to take bedside responsibility for failures in the drug supply chain for patients and that absence of specific drugs (such as succinylcholine, vasoactive agents, or propofol) are more concerning than other shortages. The case performed influences such concerns. Providers express uncertainty about how to best inform parents about drug shortages that could negatively affect care.
