Anesthesia Care Providers’ Based Interdisciplinary Peri-operative Cross-Over Post-Market - Safety- Surveillance: Is it Futuristic Patient Safety Idea? Running Title: Post-Hire PMSS for Interventionists

Education and practice of medicine potentially provides an unexplored avenue for anesthesia care providers wherein currently practiced anesthesia care providers’ initiated quality-assurance (QA) can grow out of the bounds of peri-anesthesia events. These QA processes should expand into anesthesia care providers’ based interdisciplinary peri-operative cross over post-market (post-hire) safety surveillance (PMSS) as similar to PMSS for devices1 and drugs2. Anesthesia care providers witness plethora of surgical interventions, multiple ways of performing same interventions and comparative peri-operative variability across surgical operators. Hence, their understanding of peri-operative outcomes with system- and operator-based risk factors can guide them to generate a local and indigenous rating system for operators that guide (a) the operators themselves, (b) their supervisory administrators, and (c) their paying patients to make appropriate decisions wherein consequently (a) the operators are given procedure-specific privileges based on their personal understanding of their limitations, (b) the administrators’ decisions are guided by statistical analysis of local peri-operative outcomes and (c) the patients’ shopping capabilities are enhanced by transparent local ratings of the operators’ procedures-specific proficiency.