The safety of anaesthesia delivered by rural generalist anaesthetists: a scoping review of the literature

Background: Rural Generalist Anaesthetists (RGAs) are central to the delivery of healthcare in much of rural and remote Australia. This paper details a systematic review of the literature specifically asking the question: ‘What is the current evidence of the ‘safety’ of anaesthesia delivered by RGAs?’
Methods: six databases were searched using the terms including: safety, rural, anaesthetics, general practitioners, and associated search terms. Relevant papers were assessed for rigor and information was summarised using qualitative grid analysis that included information on the study setting, participants, methods, limitations, and key result areas. The primary author developed key themes from the data which were refined in discuss with other authors.
Results: The safety of RGAs was described using five concepts: Appropriate training and leadership; rates of complications; volume or scope of practice; access to equipment; and case selection.
Conclusions: RGAs are pivotal in the delivery of healthcare in rural and remote communities. The sparce literature available on RGA safety is broadly grouped into 5 areas. There is a need to characterise and describe the role of RGAs, review and revise training and education, recognise RGA scope of practice and understand how RGAs lead the management of safety and risk in their practice.