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Ghaith S, Campbell RL, Pollock JR, et al. Healthcare (Basel). 2022;10:1328.
Obstetric and gynecologic (OB/GYN) physicians are frequently involved in malpractice lawsuits, some of which result in catastrophic payouts. This study categorized malpractice claims involving OB/GYN trainees (students, residents, and fellows) between 1986 and 2020. Cases are categorized by type of injury, patient outcome, category of error, outcome of lawsuit, and amount of settlement.
Oliver JB, Kunac A, McFarlane JL, et al. JAMA Surg. 2022;157:211-219.
Physician autonomy is an important component to medical training, but carries risks to patient safety. This retrospective cohort study used VA Surgical Quality Improvement Program (VASQIP) data from July 2004 through September 2019 to examine resident operative autonomy impacts patient outcomes. Findings indicate that surgical procedures performed by residents alone were not associated with higher rates of mortality or morbidity compared to procedures performed with the assistance of attending surgeons or by attending surgeons alone.
Etheridge JC, Moyal-Smith R, Sonnay Y, et al. Int J Surg. 2022;98:106210.
Non-technical skills such as communication, teamwork, decision-making, and situational awareness are responsible for a significant proportion of surgical errors. The COVID-19 pandemic increased the stress in the operating room, associated with increased risk of exposure and shortage of resources. This study compared pre- and post-COVID direct observations during live operations and found that non-technical skills were equivalent; there was a small, but statistically significant, improvement in teamwork and cooperation skills.

Ruskin KJ, ed. Curr Opin Anaesthesiol. 2021;34(6):720-765

Anesthesia services are high risk despite progress made in the specialty to improve its safety. This special section covers issues that affect anesthesia safety such as critical incident debriefing, human factors, and educational strategies.
Urban D, Burian BK, Patel K, et al. Ann Surg. 2021;2:e075.
The WHO surgical safety checklist has been implemented in healthcare systems around the world. Survey responses from 2,032 surgical team members from high-income countries suggest that most respondents perceive the checklist as enhancing patient safety, but that not all team members are engaging with its use or feel confident in their role in the checklist process.
Speaks L, Helmer SD, Quinn KR, et al. J Surg Educ. 2021;78:e145-e153.
Balancing resident autonomy and supervision is an ongoing challenge in medical training. The authors reviewed patient data to identify adverse outcomes (e.g., complications, readmissions, reoperation, mortality) undergoing common general surgery procedures performed by, or indirectly supervised by, attending surgeons or the chief resident service. Findings suggest that indirect supervision of appendectomies, cholecystectomies, and hernia repairs by the chief resident surgery service is safe and can serve as a model to enhance resident autonomy during training.
Gabrysz-Forget F, Zahabi S, Young M, et al. J Surg Educ. 2021;78:2020-2029.
An essential part of resident training is error recovery- recognizing an error has occurred and strategizing how to correct the error to maximize patient safety. Through interviews with surgical residents, barriers and facilitators to experience error recovery were supervision, self, surgical context, and situation safeness. Focusing on these factors may enhance residents’ ability to develop their error recovery skills.
Awan M, Zagales I, McKenney M, et al. J Surg Educ. 2021;78:e35-e46.
In 2011, the Accreditation Council for Graduate Medical Education (ACGME) updated the duty hour restrictions (DHR) for medical residents to increase resident well-being. This review focused on surgical patient outcomes, resident case volume, and resident quality of life following the implementation of the 2011 update. Results showed DHR did not improve patient safety or surgical resident quality of life. The authors suggest future revisions meant to improve resident well-being not focus solely on hours worked in a single shift or week.
Urman RD, Seger DL, Fiskio JM, et al. J Patient Saf. 2021;17:e76-e83.
Harm from opioids is a widely recognized patient safety issue, and potential harm associated with short-term use is a growing area of concern. This analysis of a previously opioid-free surgical population identified a high rate of potential opioid-related adverse drug events (ORADEs); risk was strongly associated with route and duration of post-operative opioid administration. The presence of an ORADE was associated with longer postoperative length of stay, higher hospitalization costs, lower odds of discharge home, and higher odds of death.
Gabrysz-Forget F, Young M, Zahabi S, et al. J Surg Educ. 2020;77:1552-1561.
This survey of surgical residents explored their experiences and perceptions of error recovery training (i.e., how to recognize and manage a technical error in order to ensure patient safety). Nearly all respondents thought error recovery was a key competency, yet only one-third felt they were adequately trained to recover from major events. Error recovery should be incorporated into formal surgical curriculum to support trainees and increase surgical safety.
Dieplinger B, Egger M, Jezek C, et al. Am J Infect Control. 2020;48:386-390.
This observational study enrolled 2,576 women undergoing cesarean delivery at a single tertiary care hospital over a five-year period to evaluate the impact of an evidence-based bundle on surgical site infections. The comprehensive and multidisciplinary bundle included preoperative, intraoperative and postoperative actions. Implementation of the bundle resulted in a 60% reduction in the risk of surgical site infections, from 1.5% in the preintervention period to 0.56% after implementation.
Russ S, Latif Z, Hazell AL, et al. JMIR Mhealth Uhealth. 2019;8.
Using a participatory action research approach, this study evaluated a smartphone app intended to empower surgical patients and caregivers to help optimize their care. Forty-two patients were enrolled in the study and they underwent a variety of different surgical procedures. Most patients felt that app was useful and informative (79%), was easy to use (74%) and helped participants to ask better questions (76%) and feel more involved in conversations about their care. However, almost half of participants (48%) were unsure about how the app could affect safety, citing that safety was the responsibility of the clinical staff alone rather than patients.
Shapiro FE, ed. Int Anesthesiol Clin. 2019;57:1-162.
This publication presents patient safety concepts for anesthesia practice, including decision aids to educate and empower patients about anesthesia choice, environmental hazards, interpersonal communication, team training, and use of technology and simulation as educational tools.
Suliburk JW, Buck QM, Pirko CJ, et al. JAMA Netw Open. 2019;2:e198067.
Surgeon technical skill, real-time problem solving, and communication quality are essential for avoiding harm during surgery. This study found that those types of human errors were responsible for 51.6% of 188 surgical adverse events at 3 hospitals. A past PSNet perspective delineates the evolution of surgical patient safety.
Casali G, Cullen W, Lock G. J Thorac Dis. 2019;11:S998-S1008.
Nontechnical skills, such as teamwork, communication, and leadership, are essential human-centered components of safe surgical practice. This commentary discusses contextual characteristics needed to support nontechnical skill development to improve health care outcomes. The authors recommend a cultural shift away from focusing on technical performance to one that incorporates training in nontechnical skills.
London, UK: Royal College of Surgeons of England; 2019.
Introducing innovations in practice involves taking calculated risks. To ensure patient safety, new techniques should be accompanied by training, oversight, and heightened awareness of the learning curve. This book provides a framework to guide the design and introduction of new surgical procedures into regular practice. It includes recommendations for auditing, cost assessment, and effectiveness review.
Dasani SS, Simmons KD, Wirtalla CJ, et al. J Surg Educ. 2019;76:1319-1328.
Surgical proficiency gained from performing a higher volume of certain procedures is associated with fewer errors. This study used data from the National Surgical Quality Improvement Program to examine uncommon procedures and their surgical complication rates, with and without trainee participation. As expected, uncommon operations entailed significant rates of morbidity and mortality. Resident involvement was associated with higher likelihood that a patient in distress would be successfully resuscitated but was also associated with a longer operative time. The authors suggest that simulation training for uncommon procedures for residents may improve outcomes. A PSNet perspective reflected on patient safety in surgery.
Royal College of Surgeons of England; RCS.
Physical demands and technical complexities can affect surgical safety. This resource is designed to capture frontline perceptions of surgeons in the United Kingdom regarding concerning behaviors exhibited by their peers during practice to facilitate awareness of problems, motivate improvement, and enable learning.