A d a Anneslhesiol Scand 1994: 38: I Prinkd in Denmark - ail rights reserved

Capyriglrt 0 Aatn Anaesthesiol Scand IW4

Acta Anaesthesiologica Scandinavica ISSN 0001-51 72

Editorial

Looking into the future

It is with humility that I assume the editorship of Acta Anaesthesiologica Scandinavica. When Jan Eklund took over in 1986, he had already been coeditor for no less than 12 years. Thus, he can look back on almost 20 years of service to our journal. During these years, Acta has become a leading journal. Jan Eklund has done a great service to Acta and to the promotion of Scandinavian anaesthesiology.

Future challenges are many. The days are over when a journal sold itself. Today there is strong competition not only from an increasing number of journals, but also from abstract services and electronic data bases offering “instant satisfaction” to the busy reader. The only reliable weapon in this situation is quality, quality of the work published and quality of editorial effort. This is our challenge, and we take i t seriously. We feel strongly that we have quality to offer from the Scandinavian countries. However, Acta Anaes- thesiologica is also an international journal. In 1992 55% of our articles came from other countries. This is a most welcome trend. Anaesthesiology as a speciality is rapidly expanding. The trend in Scandinavia is for anaesthesiology to include postoperative and intensive care as well as pain therapy and emergency medicine. We welcome articles from all these disciplines.

When looking at our standards of care ( l ) , we work on the same lines and principles in the five countries. The well-educated anaesthesia nurse is an important element in our operating rooms, in contrast to some other countries. It is my conviction, that this system improves quality and enhances safety for our patients. Anaesthesiology as a speciality has played a leading role internationally when it comes to developing stan- dards of care. Key words in this process are better systems and less individualism. This work progresses rapidly (2, 3) . However, there are problems. We are met with increasing demands for efficiency as well as quality, and society is less inclined to forgive if some- thing goes wrong. At the same time, there are strong financial limitations. There is an increasing gap be-

tween peoples’ expectations and what is financially possible. As doctors and anaesthesiologists, we may be caught in the middle. The answer is, in part, better systems, better organization and good cost-benefit re- search.

Sub-specialization is also taking place. Clinical an- aesthesia is splitting into pediatric, regional, neuro, obstetric and cardiovascular anaesthesia. This is both inevitable and desirable and to the benefit of research as well as clinical skills. However, this is also a problem. I believe in the old maxim: “United we stand, divided we (may) fall.” There are many facets to this problem. We must be aware of it and develop structures that can prevent any undesirable development. It is import- ant to keep the “family” together.

In Europe, there is an increasing number of bodies in anaesthesiology, I am thinking of the European Academy of Anaesthesiology (EAA) with its valuable educational efforts and the newly started European Society of Anaesthesiology (ESA), which claims to be a more open and democratic organization. In addition, we have the European section of the World Federation (WFSA), with its congress every fourth year. It is my hope that we can somehow manage to unite these good forces and end up with one strong, joint European organization to supplement the various national and regional societies. Competition is good, but so is co- operation and flexibility. In Acta Anaesthesiologica Scandinavica, we hope to play an active part in this process.

REFERENCES 1 , Rosenberg P, Gisvold S E, Flaatten H, Nuutinen L 0, Tryggva-

son B, Viby-Mogensen J. Guidelines for anaesthesia care in the Nordic countries. Acta Anaesthesiol &and 1992: 36: 741-744.

2. International task force on anaesthesia safety. Vickers M D, Robins D S, eds. Eur 3 Anaesthesiol 1993: (suppl 7) : 1-44.

3. Aitkenhead A R , Booij L H, Dhainaut J F, et al. International standards for safety in the intensive care unit. Inlensive Care Med 1993: 19: 178-181.

Suen Erik Gisuold

0 Acta Anaesthesiologica Scandinavica 38 (1994)