Slide 21. Process improvement: Significant change in national guidelines The "Seven Pillars" Approach: Crossing the Patient Safety-Medical LiabilityOn April 13, 2012, Timothy McDonald, MD, JD, made this presentation at the meeting of the National Advisory Council. July 1, 2011, American Society of Anesthesiologists (ASA).Specifically, in section 3.2.4 of the Standards for Basic Anesthetic Monitoring, the ASA states, "...During moderate or deep sedation the adequacy of ventilation shall be evaluated by continual observation of qualitative clinical signs and monitoring for the presence of exhaled carbon dioxide unless precluded or invalidated by the nature of the patient, procedure, or equipment. Previous Slide Contents Next Slide Current as of August 2012 Internet Citation: Slide 21. Process improvement: Significant change in national guidelines: The "Seven Pillars" Approach: Crossing the Patient Safety-Medical Liability. August 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/nac/2012-04-nac/mcdonald/mcdonald21.html