Health ProfessionsPerioperative MedicineSurgeryHealthcare Quality ImprovementMedical EthicsPatient SafetyAdverse Event ReportingMedical NegligenceStandard Of CareSurgical ComplicationsSurgical ErrorSurgical SafetyClinical Practice Guidelines ImplementationError Prevention In SurgeryPatient Safety In SurgeryPostoperative Adverse Event ReportingQuality Improvement In SurgerySurgical Adverse Event ReportingSurgical AuditSurgical Error Prevention
We all recognize and accept that adverse events occur with some frequency in surgery and that all departments meet regularly to review them. Since adverse events and "mistakes" have the potential for delaying recovery and injuring surgical patients, an ethical mandate exists to do all that can be done to prevent harm. This article suggests that there are 5 issues within the practice of surgery that have inhibited improvement in quality: (1) inadequate data about the incidence of adverse events, (2) inadequate practice guidelines or protocols and poor outcome analysis, (3) a culture of blame, (4) a need to compensate "injured" patients, and (5) difficulty in truth telling.
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The Nature of Adverse Events in Hospitalized Patients
Lucian L. Leape, Troyen A. Brennan, Nan M. Laird et al. · New England Journal of Medicine · 1991 · 3.8K citations
An alternative strategy for studying adverse events in medical care
Lori B. Andrews, Carol Stocking, Thomas J. Krizek et al. · The Lancet · 1997 · 531 citations
Health Professions, Internal Medicine, Clinical Medicine +11