Karen L. Posner

My areas of research expertise include patient safety, medical liability, cost, quality, and outcomes of medical care, and clinical decision-making.

Since 1986, I have collaborated on the American Society of Anesthesiologists Closed Claims Project. This project investigates the causes of patient injury associated with anesthesia through the collection and analysis of a nationwide database of malpractice claims against anesthesiologists. A methodology is thereby provided for collection of large sets of cases involving relatively infrequent complications of anesthesia. Previously unrecognized patterns of injuries have been revealed and hypotheses about causative mechanisms generated due to investigative efforts in relation to this project. Changes in anesthesia liability associated with changes in practice are also being tracked.

A similar study of surgical malpractice claims sponsored by the American College of Surgeons Patient Safety and Liability Committee was conducted in 2004-2006. This investigation of general surgery malpractice claims provided new insights in to surgical patient safety.

In 1994, I collaborated on the establishment of a national registry for reporting cases of cardiac arrest and death in pediatric patients during administration or recovery from anesthesia. The goal of this Pediatric Perioperative Cardiac Arrest Registry is to collect cases of unexplained cardiac arrest and death for in-depth analysis in search of causative factors.

The Postoperative Visual Loss Registry was established in 1999 to investigate mechanisms of blindness following non-ophthalmic surgery. Detailed case reports from throughout the United States will be analyzed in an attempt to determine risk factors for ischemic optic neuropathy and other postoperative vision complications.

As Associate Director for Research of the Health Services Research Program in Anesthesiology at the University of Washington, I work with clinicians in developing research projects investigating the cost, quality, and access to anesthesia services. Our current program areas include operating room cost effectiveness and quality assurance and improvement.

My research in physician decision-making has included investigation of the reliability of physician peer review judgments and bias peer review. I have also investigated the role of non-medical factors in physician decision-making. My study of the interactions of anesthesiologists and surgeons revealed bureaucratic and charismatic factors influencing treatment decisions.

Academic Experience:
- Adjunct Research Associate Professor, Department of Anthropology, University of Washington, 1996-present
- Associate Director for Research, Health Services Research Program in Anesthesiology, Department of Anesthesiology, University of Washington, 1994-present
- Department of Anesthesiology Quality Improvement Committee, University of Washington (ex officio), 1991-present
- Anesthesia Patient Safety Foundation, Scientific Evaluation Committee, 1997-present; Editorial Board, 1998-present

Business Experience:
Consultancies:
Difficult Airway Task Force, American Society of Anesthesiologists, 1992
IDEAL Error Reporting System to Improve Safety of the Blood Supply, University of Texas Southwestern Medical School, 1995