The Anaesthetic Services Programme Encompassing Nova Scotia (ASPENS).

A comprehensive peer review programme for anaesthesia departments in Nova Scotia was implemented in 1987 by the anaesthesia community. Departments are reviewed by peers at the request of the Head, Department of Anaesthesia, and the President of the Medical Staff. A confidential report with recommendations is written. Twenty-six reviews have been completed (to June 1993) and have most often documented deficiencies in: design of the anaesthesia record, anaesthesia staff recruitment, inadequate documentation of policies for anaesthesia and post-anaesthesia care, peer review/quality assurance processes, organizational structure of hospital medical staffs and operating room committees, and use of anaesthesia equipment that does not meet current (at date of review) CSA standards. In the four hospitals that have been reviewed twice, 24 of the 30 deficiencies noted on the first review had been corrected before the second review which occurred three to five years later. Nine new deficiencies were noted. Departments are encouraged to request a review every four or five years.