Faculty Opinions recommendation of A policy-based intervention for the reduction of communication breakdowns in inpatient surgical care: results from a Harvard surgical safety collaborative.

2011 ◽  
Author(s):  
Mitchell Tsai ◽  
Jessica Heath
Keyword(s):  
Surgical Care ◽  
Surgical Safety ◽  
Communication Breakdowns

A Policy-Based Intervention for the Reduction of Communication Breakdowns in Inpatient Surgical Care: Results From a Harvard Surgical Safety Collaborative

2011 ◽  
Vol 66 (9) ◽  
pp. 535-537
Author(s):  
Alexander F. Arriaga ◽  
Andrew W. Elbardissi ◽  
Scott E. Regenbogen ◽  
Caprice C. Greenberg ◽  
William R. Berry ◽  
...  
Keyword(s):  
Surgical Care ◽  
Surgical Safety ◽  
Communication Breakdowns

scholarly journals Ethical considerations and patient safety concerns for cancelling non-urgent surgeries during the COVID-19 pandemic: a review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nolan J. Brown ◽  
Bayard Wilson ◽  
Stephen Szabadi ◽  
Cameron Quon ◽  
Vera Ong ◽  
...  
Keyword(s):  
Medical Ethics ◽  
Health Care Access ◽  
Elective Surgery ◽  
Surgical Techniques ◽  
Surgical Care ◽  
Health Crisis ◽  
Surgical Safety ◽  
Care Access ◽  
Urgent Surgery ◽  
Starting Point

AbstractAt the time of writing of this article, there have been over 110 million cases and 2.4 million deaths worldwide since the start of the Coronavirus Disease 2019 (COVID-19) pandemic, postponing millions of non-urgent surgeries. Existing literature explores the complexities of rationing medical care. However, implications of non-urgent surgery postponement during the COVID-19 pandemic have not yet been analyzed within the context of the four pillars of medical ethics. The objective of this review is to discuss the ethics of elective surgery cancellation during the COVID-19 pandemic in relation to beneficence, non-maleficence, justice, and autonomy. This review hypothesizes that a more equitable decision-making algorithm can be formulated by analyzing the ethical dilemmas of elective surgical care during the pandemic through the lens of these four pillars. This paper’s analysis shows that non-urgent surgeries treat conditions that can become urgent if left untreated. Postponement of these surgeries can cause cumulative harm downstream. An improved algorithm can address these issues of beneficence by weighing local pandemic stressors within predictive algorithms to appropriately increase surgeries. Additionally, the potential harms of performing non-urgent surgeries extend beyond the patient. Non-maleficence is maintained through using enhanced screening protocols and modifying surgical techniques to reduce risks to patients and clinicians. This model proposes a system to transfer patients from areas of high to low burden, addressing the challenge of justice by considering facility burden rather than value judgments concerning the nature of a particular surgery, such as cosmetic surgeries. Autonomy can be respected by giving patients the option to cancel or postpone non-urgent surgeries. However, in the context of limited resources in a global pandemic, autonomy is not absolute. Non-urgent surgeries can ethically be postponed in opposition to the patient’s preference. The proposed algorithm attempts to uphold the four principles of medical ethics in rationing non-urgent surgical care by building upon existing decision models, using additional measures of resource burden and surgical safety to increase health care access and decrease long-term harm as much as possible. The next global health crisis will undoubtedly present its own unique challenges. This model may serve as a comprehensive starting point in determining future guidelines for non-urgent surgical care.

A Policy-based Intervention for the Reduction of Communication Breakdowns in Inpatient Surgical Care

2011 ◽  
Vol 253 (5) ◽  
pp. 849-854 ◽  
Author(s):  
Alexander F. Arriaga ◽  
Andrew W. Elbardissi ◽  
Scott E. Regenbogen ◽  
Caprice C. Greenberg ◽  
William R. Berry ◽  
...  
Keyword(s):  
Surgical Care ◽  
Communication Breakdowns

scholarly journals Modified surgical safety checklist (mSSC)- a must to avoid disaster in neurosurgical procedures!

2017 ◽  
Vol 14 (3) ◽  
pp. 7-12
Author(s):  
Amit Thapa ◽  
Bidur KC ◽  
Bikram Shakya ◽  
Shusma Bhurtyal
Keyword(s):  
Surgical Care ◽  
World Health ◽  
Surgical Patient ◽  
Neurosurgical Procedures ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Emergency Procedures ◽  
Machine Failure ◽  
Neurosurgical Patients ◽  
Health Organization

The World Health Organization (WHO) introduced surgical safety checklist (SSC) as a part of Second Global Patient Safety Challenge: Safe Surgery Saves Lives to address the safety of surgical care. Althoughfound to be benefi cial for general surgical patient, we introduced certain modification to suit neurosurgical patients and hereby present our experience with the modified checklist.We introduced the modified SSC in July 2012 for neurosurgical purpose after we identified minor but common errors in carefully audited 100 patients in our operating theatre. Modification included checklists in pre procedure room, during sign in enquiring for pulse oximeter (for local anesthetic procedures) and lastly during sign out an elaborated list of items to guarantee safe transfer of the patients. Nurses and doctors were trained and SSC was methodically administered.Outcome as number of complications was evaluated and graded according to no harm, low harm, moderated harm, severe harm and death. During last 5 years (July 2012 to June 2017), 1310 patients undergoing surgical procedures in neurosurgical theatre at KMCTH were studied. Modified SSC was used in both routine (50.5%) and emergency cases (49.5%), of which compliance was 80% and 55% respectively. Poor compliance was due to ignorance of its use, emergency nature of procedure, change of staff. Completeness of mSSC was found in 70% cases with most left out part of mSSC was during signing out (i.e during transfer of patients). Use of mSSC identified many common but minor negligent acts on part of doctors, nurses and OR technicians which could be rectified in time and hence avoided any major mishaps. Age of the patients ranged from newborn to 98 year old. There were no major mishaps including death on table events. Despite confirming during mSSC checklist, machine failure occurred in 10 cases (0.8%) which were of low harm category. The total time taken for performing and filling the checklist took roughly 7 minutes.We modified WHO surgical safety checklist to include post operative transfer out to recovery room and used it in both routine and emergency procedures. This has helped us to avoid major mishaps during and after the neurosurgical procedures. We recommend stringent use of SSC in all neurosurgical centre and advise suitable local modifications according to prevailing conditions for special procedures or locations.Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, page: 7-12

scholarly journals Surgical safety checklist implementation and its impact on patient safety

2018 ◽  
Vol 5 (11) ◽  
pp. 3640 ◽  
Author(s):  
H. N. Dinesh ◽  
Ravya R. S. ◽  
Sunil Kumar V.
Keyword(s):  
Patient Safety ◽  
Multiorgan Failure ◽  
Surgical Care ◽  
Education Programme ◽  
Median Number ◽  
Post Intervention ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Safety Outcome ◽  
Checklist Implementation

Background: Surgery has become an integral part of global health care, with an estimated 234 million operations performed yearly. Surgical complications are common and often preventable. Although surgical and anesthetic caregivers seek to deliver optimal quality in peri-operative service, surgery still carries considerable risk for the patient. WHO surgical safety checklist outlines essential standards of surgical care and has been shown to reduce complications and death associated with surgery.Methods: Pre-intervention and post-intervention study. The effect on patient outcomes and documentation of WHO surgical safety checklist was examined. After an education programme, the checklist implementation and patient safety outcome indicators were studied.Results: Checklist compliance increased over time. The median number of items documented was 16. After implementation of the checklist, mortality decreased from 3.13% to 2.85%. Most causes of death did not significantly differ between the implementation periods, except for multiorgan failure and major bleeding. Adjustment of the association between implementation period and outcome for all variables revealed a decreased mortality after checklist implementation.Conclusions: Implementation of the checklist showed improved outcomes. Use of the WHO surgical safety checklist in urgent operations is feasible and should be considered. Implementation proved neither costly nor lengthy. Further research is needed to confirm these findings and reveal additional factors supportive of checklist implementation.

scholarly journals The 14th Bethune Round Table Conference on International Surgery1. Sustainable partnerships and local capacity building: Ukraine–Canada experience.2. COSECSA, achievements and challenges in improving global surgery.3. The VCU international trauma system development program in Central and South America.4. Establishing a contextually appropriate laparoscopic program in resource restricted environments: experience in Botswana.5. Collaborative care to reduce maternal deaths from postpartum hemorrhage.6. Building a sustainable collaboration and an interprofessional team in pediatric surgical care: an interim report.7. Women in surgery: factors hindering women from being surgeons in Zimbabwe.8. Inadequate Hepatitis B vaccination among surgeons practising in Ethiopia — Are we playing with fire? A cross-sectional study.9. Global met need for emergency obstetric care: a meta-analysis.10. Improving service-based obstetric care to reduce maternal mortalities.11. Emergency and Essential Surgical Care capacity-building through skills training: evidence from Meghalaya, India.12. Evaluation of the trauma quality indicators using trauma registry in low resource settings.13. Evaluation of prehospital care: Does Bolivia need a trauma first responders course?14. Timing of surgery and functional outcomes in patients presenting with ankle fractures to a teaching hospital in a developing country.15. A 1-year review of surgical complications of diabetes in Soroti Regional Referral Hospital, Uganda.16. Effect of surgical safety checklist implementation on culture of patient safety in Rwanda.17. Reducing critical incidents in neonatal anesthesia in a low resource setting.18. Ultrasound guided regional anesthesia — a multicentre feasibility trial for use in low resource settings.19. Understanding the burden of surgical congenital anomalies in Kenya: a mixed-methods approach.20. Pediatric surgery outcomes in low- and middle-income African countries: a scoping review of the recent literature.21. Providing more than health care: the dynamics of humanitarian surgery efforts on the local microeconomy.22. Low-fidelity simulation to teach anaesthetists’ non-technical skills (ANTS) in Rwanda.23. Pulse oximeter distribution, a journey to anesthesia safety in the developing world: case of Rwanda.24. Evidence based best practice in medical disaster response?25. Measuring and comparing the cost-effectiveness of surgical care delivery in low-resource settings: cleft lip and palate as a model.26. Prospective data collection at a district hospital in Rwanda.27. Evidence based surgery in low resource settings: the missed opportunity in graduate dissertations at Makerere University.P1. Anesthetic audit of WHO surgical safety checklist implementation in a rural community to reduce maternal and child mortality.P2. Epidemiology, management and outcome of malignancies surgically treated at a rural referral hospital in Butare, Rwanda.P3. Importance and impact of surgical camp — ECSA 2013 Swaziland experience.P4. Disease burden of intimate partner violence in Rwanda and US trauma centres: identifying surgical need using DALYs.P5. Improved pediatric surgical service outcome in resource limited practice — strategies and challenges.P6. Overcrowding of accident and emergency units: Is it a growing concern in Nigeria?P7. Building local capacity for improved surgical safety in a resource poor setting.P8. Tertiary Trauma Survey: How much are we missing in the evaluation of our patients?P9. Development of an enterostoma care team at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.P10. Assessing knowledge dissemination from the annual Bethune Round Table on International Surgery Conference.P11. Photovoice: engaging youth in rural Uganda in articulating health priorities through participatory section research.P12. Burn care in Nepal: a retrospective review.P13. Burn care checklist in Nepal: a pilot study.P14. Pediatric surgical care in conflict zones: the Médecins Sans Frontières experience in 2012.P15. Gluteal fibrosis: a case series in eastern Uganda. Could our malarial treatment be causing long-term disability?P16. The bacterial pathogens and possible sources contributing to infection and mortality in the Burn Care Unit, Georgetown Public Hospital Corporation, Guyana.P17. Standardizing goals and objectives for resident electives in international surgery.P18. Dr. Lucille Teasdale-Corti: a legacy of empowerment.P19. Outcomes of patients that underwent laparotomy at a large referral hospital in Rwanda over a one-year period.P20. The Haiti Breast Cancer Initiative: preliminary epidemiological data.P21. User fees and essential surgical services in Tan-zania: theory, practice and impact.

2014 ◽  
Vol 57 (3 Suppl 1) ◽  
pp. S1-S16
Author(s):  
I. Mogilevkina ◽  
P.G. Jani ◽  
M. Aboutanos ◽  
A.G. Bedada ◽  
O. Ajuzieogu ◽  
...  
Keyword(s):  
Surgical Care ◽  
Obstetric Care ◽  
Round Table ◽  
Referral Hospital ◽  
Evidence Based ◽  
Low Resource Settings ◽  
Surgical Safety ◽  
Low Resource ◽  
Burn Care ◽  
Checklist Implementation

scholarly journals A Smartphone App Designed to Empower Patients to Contribute Toward Safer Surgical Care: Community-Based Evaluation Using a Participatory Approach

10.2196/12859 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e12859
Author(s):  
Stephanie Russ ◽  
Zahira Latif ◽  
Ahmarah Leah Hazell ◽  
Helen Ogunmuyiwa ◽  
Josephine Tapper ◽  
...  
Keyword(s):  
Public Involvement ◽  
Surgical Care ◽  
Research Process ◽  
Surgical Patients ◽  
Smartphone App ◽  
Good Representation ◽  
Minority Ethnic Group ◽  
Voluntary Organizations ◽  
Care Community ◽  
Surgical Safety

Background MySurgery is a smartphone app designed to increase patient and carer involvement in behaviors that contribute toward safety in surgical care. Objective This study presents a pilot evaluation of MySurgery in which we evaluated surgical patients’ perceptions of the app in terms of its content, usability, and potential impacts on communication and safety. Methods A participatory action research (PAR) approach was used to formulate a research steering group consisting of 5 public representatives and 4 researchers with equal decision-making input. Surgical patients were recruited from the community using multiple approaches, including Web based (eg, social media, recruitment websites, and charitable or voluntary organizations) and face to face (via community centers). Participants referred to MySurgery before, during, and after their surgery and provided feedback via an embedded questionnaire and using reflective notes. Results A diverse mix of 42 patients took part with good representation from 2 “seldom heard” groups: those with a disability and those from a black, Asian, or minority ethnic group. Most were very supportive of MySurgery, particularly those with previous experience of surgery and those who felt comfortable to be involved in conversations and decisions around their care. The app showed particular potential to empower patients to become involved in their care conversations and safety-related behaviors. Perceptions did not differ according to age, ethnicity, or length of hospital stay. Suggestions for improving the app included how to make it more accessible to certain groups, for example, those with a disability. Conclusions MySurgery is a novel technology-driven approach for empowering patients to play a role in improving surgical safety that seems feasible for use within the United Kingdom’s National Health Service. Adopting a PAR approach and the use of a diversity strategy considerably enhanced the research process in terms of gaining diverse participant recruitment and patient and public involvement. Further testing with stakeholder groups will follow.

scholarly journals Validation of a Norwegian version of SURgical PAtient Safety System (SURPASS) in combination with the World Health Organizations’ Surgical Safety Checklist (WHO SSC)

2019 ◽  
Vol 8 (1) ◽  
pp. e000488 ◽  
Author(s):  
Anette Storesund ◽  
Arvid Steinar Haugen ◽  
Hilde Valen Wæhle ◽  
Rupavathana Mahesparan ◽  
Marja A Boermeester ◽  
...  
Keyword(s):  
Patient Safety ◽  
Focus Groups ◽  
Content Validity ◽  
Surgical Care ◽  
Safety System ◽  
World Health ◽  
Surgical Patient ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Norwegian Version

IntroductionSurgical safety checklists may contribute to reduction of complications and mortality. The WHO’s Surgical Safety Checklist (WHO SSC) could prevent incidents in operating theatres, but errors also occur before and after surgery. The SURgical PAtient Safety System (SURPASS) is designed to intercept errors with use of checklists throughout the surgical pathway.ObjectiveWe aimed to validate a Norwegian version of the SURPASS’ preoperative and postoperative checklists for use in combination with the already established Sign In, Time Out and Sign Out parts of the WHO SSC.Methods and materialsThe validation of the SURPASS checklists content followed WHOs recommended guidelines. The process consisted of six steps: forward translation; testing the content; focus groups; expert panels; back translation; and approval of the final version. Qualitative content analysis was used to identify codes and categories for adaption of the SURPASS checklist items throughout Norwegian surgical care. Content validity index (CVI) was used by expert panels to score the relevance of each checklist item. The study was carried out in a neurosurgical ward in a large tertiary teaching hospital in Norway.ResultsTesting the preoperative and postoperative SURPASS checklists was performed in 29 neurosurgical procedures. This involved all professional groups in the entire surgical patient care pathway. Eight clinical focus groups revealed two main categories: ‘Adapt the wording to fit clinical practice’ and ‘The checklist items challenge existing workflow’. Interprofessional scoring of the content validity of the checklists reached >80% for all the SURPASS checklists.ConclusionsThe first version of the SURPASS checklists combined with the WHO SSC was validated for use in Norwegian surgical care with face validity confirmed and CVI >0.80%.Trial registration numberNCT01872195.

Sign in / Sign up

Export Citation Format

Share Document