Last week we discussed latent factors in the OR and other things that can go wrong in the OR itself (see our October 23, 2012 Patient Safety Tip of the Week “Latent Factors Lurking in the OR”. This week we are going to discuss some of the issues that occur well before the patient goes to the OR that may have an impact on patient safety, patient outcomes, and even hospital finances. And in a future column we’ll deal with issues related to postoperative care.
Our August 2011 What’s New in the Patient Safety World column “New Wrong-Site Surgery Resources” highlighted
Some of the booking and scheduling issues predisposing to wrong site surgery (their list plus some of our own) are:
A new study (Wu 2012) did a qualitative and quantitative analysis of errors occurring during the surgical booking/scheduling process and identified not only patient safety issues but also analyzed the costs associated with the delays such errors end up causing. Looking at over 17,000 surgeries they found a booking error rate of 0.86%. Of the booking errors wrong side was listed on 36%. Another 25% were incomplete and may not have included the laterality. Wrong approach (eg. laparoscopic rather than open) accounted for 17% of the errors. Other booking errors included wrong patient information, wrong procedure, wrong site, and even wrong patient.
The type of booking error was influenced by the nature of the surgical specialty. For example, most wrong approach errors were in general surgery but laterality errors were more common in plastic surgery, orthopedic, ophthalmologic, and ENT procedures.
Some of our prior columns related to wrong-site surgery:
Patient Safety Tip of the Week columns:
September 23, 2008 “”
June 5, 2007 “ ”
March 11, 2008 “Lessons from Ophthalmology”
September 14, 2010 “ ”
November 25, 2008 “Wrong-Site Neurosurgery”
January 19, 2010 “Timeouts and Safe Surgery”
June 8, 2010 “Surgical Safety Checklist for Cataract Surgery”
December 6, 2010 “ ”
June 6, 2011 “Timeouts Outside the OR”
What’s New in the Patient Safety World columns:
July 2007 “ ”
August 2011 “New Wrong-Site Surgery Resources”
Wu RL, Aufses AH. Characteristics and costs of surgical scheduling errors. Am J Surg 2012; 204(4): 468-473, October 2012
checklist for the surgeon’s office
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