National trends in hospital-acquired preventable adverse events after major cancer surgery in the USA.
Approach to Improving Safety
Setting of Care
This large study used AHRQ Patient Safety Indicators (PSIs) to assess the quality of surgical care in oncology across the United States. Although the frequency of potentially avoidable adverse events after major cancer surgery has increased over the past decade, overall mortality rates declined. The highest-volume hospitals in this study had lower PSI event rates and failure-to-rescue rates compared with lower-volume hospitals. This finding differs from prior studies that had found similar complication rates across hospitals and had suggested that the higher mortality seen at low-volume hospitals could be attributed solely to failures in rescuing patients once an event occurred. The authors propose that policy changes are required to prevent specific adverse events, such as postoperative sepsis and pressure ulcers. Dr. Patrick Romano discusses the utility of using PSIs to measure patient safety in an AHRQ WebM&M interview.