In general, surgeons strive to achieve excellent results and ideal patient outcomes, however, this noble task is frequently failed. For patients, surgical complications are analogous to “friendly fire” in wartime. Both scenarios imply that harm is unintentionally done by somebody whose aim was to help. Interestingly, adverse events resulting from surgical interventions are more frequently related to system errors and a communication breakdown among providers, rather than to the imminent threat of the surgical blade “gone wrong”. Patient Safety in Surgery aims to increase the safety and quality of care for patients undergoing surgical procedures in all fields of surgery. Patient Safety in Surgery, covers all aspects related to patient safety in surgery, including pertinent issues of interest to surgeons, medical trainees (students, residents, and fellows), nurses, anaesthesiologists, patients, patient families, advocacy groups, and medicolegal experts.
Guest Editor Juan Sanchez reviews articles in Safe Surgery for the general surgeon. Articles include iatrogenesis: the nature, frequency, and science of medical errors, risk management and the regulatory framework for safer surgery medication, lab, and blood banking errors, surgeons' non-technical skills, creating safe and effective surgical teams, human factors and operating room safety, systemic analysis of adverse events: identifying root causes and latent errors, information technologies and patient safety, patient safety and the surgical workforce, measuring and preventing healthcare associated infections, the surgeon's four-phase reaction to error, universal protocols and wrong-site/wrong-patient events, unconscious biases and patient safety, and much more!
This book focuses exclusively on the surgical patient and on the perioperative environment with its unique socio-technical and cultural issues. It covers preoperative, intraoperative, and postoperative processes and decision making and explores both sharp-end and latent factors contributing to harm and poor quality outcomes. It is intended to be a resource for all healthcare practitioners that interact with the surgical patient. This book provides a framework for understanding and addressing many of the organizational, technical, and cultural aspects of care to one of the most vulnerable patients in the system, the surgical patient. The first section presents foundational principles of safety science and related social science. The second exposes barriers to achieving optimal surgical outcomes and details the various errors and events that occur in the perioperative environment. The third section contains prescriptive and proactive tools and ways to eliminate errors and harm. The final section focuses on developing continuous quality improvement programs with an emphasis on safety and reliability. Surgical Patient Care: Improving Safety, Quality and Value targets an international audience which includes all hospital, ambulatory and clinic-based operating room personnel as well as healthcare administrators and managers, directors of risk management and patient safety, health services researchers, and individuals in higher education in the health professions. It is intended to provide both fundamental knowledge and practical information for those at the front line of patient care. The increasing interest in patient safety worldwide makes this a timely global topic. As such, the content is written for an international audience and contains materials from leading international authors who have implemented many successful programs.
This issue of Surgical Clinics of North America focuses on Surgical Patient Safety and is edited by Dr. Feibi Zheng. Articles will include: Human factors approach to surgical patient safety; Teamwork and surgical team based training; Effective handoffs and transfers in surgical patient safety; Effective implementation and utilization of checklists in surgical patient safety; Standardized care pathways as a means to improve patient safety; Evolution of risk calculators and the dawn of artificial intelligence in predicting patient complications; Remote monitoring technology/use of telemedicine to detect and address surgical complications; Rescue after surgical complications; The economics of surgical patient safety; The trainee's role in patient safety/training residents and medical students in surgical patient safety; The second victim: building surgeon resiliency after complications; Processes to create a culture of surgical patient safety; Provision of defect free care: implementation science in surgical patient safety; Administrative and registry databases for patient safety tracking and quality improvement; and more!
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.
Put patient safety at the center of your surgical protocol—with this essential case-based guide Despite many advances in the practice of surgery, surgical complications continue to cause significant patient morbidity and mortality. Now more than ever, it is the responsibility of every surgeon to take the lead in understanding and mitigating complications and adverse events. Surgical Patient Safety: A Case-based Approach is your blueprint for putting this goal within reach. This timely resource gives you all the insights needed to effectively manage patient safety, covering everything from sharpening communication skills to establishing shared decision-making with patients and their families. Supplementing this important content are numerous case-based examples and exercises, supported by color illustrations, tables, figures, radiographs, and algorithms. Taken as a whole, this new textbook represents a one-stop, hands-on patient safety primer that no other sourcebook can match. Surgical Patient Safety represents a vital call to action—one designed to inspire a physician-driven initiative fostering a global culture of patient safety. Features • The latest practical patient safety tools for surgeons in training, including surgical safety checklists, intraoperative “rescue” strategies, and the global implementation of new regulatory compliance guidelines • Case-based scenarios examining technical challenges and bail-out options in the operating room • Bulleted “pearls and pitfalls” that take you through the decision-making process for diagnostic work up and revision of specific complications • Insights from renowned experts that explain how to handle malpractice lawsuits; navigate the modern dangers of electronic health records; apply the pragmatic “IKEA approach” for patient advocacy; and much more • A must-read for all practicing surgeons, independent of the surgical subspecialty
Confronted with worldwide evidence of substantial public health harm due to inadequate patient safety, the World Health Assembly (WHA) in 2002 adopted a resolution (WHA55.18) urging countries to strengthen the safety of health care and monitoring systems. The resolution also requested that WHO take a lead in setting global norms and standards and supporting country efforts in preparing patient safety policies and practices. In May 2004, the WHA approved the creation of an international alliance to improve patient safety globally; WHO Patient Safety was launched the following October. For the first time, heads of agencies, policy-makers and patient groups from around the world came together to advance attainment of the goal of "First, do no harm" and to reduce the adverse consequences of unsafe health care. The purpose of WHO Patient Safety is to facilitate patient safety policy and practice. It is concentrating its actions on focused safety campaigns called Global Patient Safety Challenges, coordinating Patients for Patient Safety, developing a standard taxonomy, designing tools for research policy and assessment, identifying solutions for patient safety, and developing reporting and learning initiatives aimed at producing 'best practice' guidelines. Together these efforts could save millions of lives by improving basic health care and halting the diversion of resources from other productive uses. The Global Patient Safety Challenge, brings together the expertise of specialists to improve the safety of care. The area chosen for the first Challenge in 2005-2006, was infection associated with health care. This campaign established simple, clear standards for hand hygiene, an educational campaign and WHO's first Guidelines on Hand Hygiene in Health Care. The problem area selected for the second Global Patient Safety Challenge, in 2007-2008, was the safety of surgical care. Preparation of these Guidelines for Safe Surgery followed the steps recommended by WHO. The groundwork for the project began in autumn 2006 and included an international consultation meeting held in January 2007 attended by experts from around the world. Following this meeting, expert working groups were created to systematically review the available scientific evidence, to write the guidelines document and to facilitate discussion among the working group members in order to formulate the recommendations. A steering group consisting of the Programme Lead, project team members and the chairs of the four working groups, signed off on the content and recommendations in the guidelines document. Nearly 100 international experts contributed to the document (see end). The guidelines were pilot tested in each of the six WHO regions--an essential part of the Challenge--to obtain local information on the resources required to comply with the recommendations and information on the feasibility, validity, reliability and cost-effectiveness of the interventions.
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
