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Journal Article > Study
Complications of daytime elective laparoscopic cholecystectomies performed by surgeons who operated the night before.
Vinden C, Nash DM, Rangrej J, et al. JAMA. 2013;310:1837-1841.
Considerable research has shown that sleep deprivation can affect cognitive performance, but the link between fatigue and clinical outcomes, particularly for surgeons, remains unclear. This case-control study sought to determine whether there was an association between sleep deprivation—defined as having performed an emergency procedure the night before—and complication rates for elective laparoscopic cholecystectomy. Although a prior single-institution study found increased complication rates for daytime procedures performed after operating the night before, this study used a much larger population-based database from Ontario, Canada and found no evidence of greater complications in patients whose surgeons had operated the night before. As duty hour restrictions for resident physicians appear to have had no effect on clinical outcomes, this study provides an argument against restricting practicing physician's duty hours.
Pelczarski KM, Braun PA, Young E. Patient Saf Qual Healthc. Sept/Oct 2010;7:20-22,25-26.
This article describes a wrong-site surgery prevention program and how it was successfully implemented in 30 hospitals.
Journal Article > Commentary
Litman RS. J Patient Saf Risk Manag. 2019 Feb 5; [Epub ahead of print].
This commentary explores how gaps in legal and regulatory structure affect anesthesia medication safety. The author advocates for use of a public health law framework to prevent certain types of perioperative medication errors made by anesthesiologists. Policy approaches that require organizations to provide prefilled syringes and barcoding scanners are suggested to avoid vial- and syringe-related mistakes.
Biel L. ProPublica. October 2, 2018.
This news article reports on systemic weaknesses that enabled a surgeon with poor skills to continue to perform procedures after numerous surgical errors that resulted in patient harm. A past PSNet perspective explored the risk of recurring medicolegal events among providers who have received unsolicited patient complaints, faced disciplinary actions by medical boards, or accumulated malpractice claims.
NHS England Patient Safety Domain, National Safety Standards for Invasive Procedures Group. London, UK: National Health Service; 2015.
Patients face risks when undergoing invasive procedures. This report provides recommendations developed by multidisciplinary consensus and outlines how organizations can implement the standards to improve safety of invasive procedures.
Journal Article > Commentary
Whittemore AD. Ann Surg. 2009;250:357-362.
Discussing safe care in the context of both systems failures and individual responsibility, this commentary advocates for directly addressing disruptive and impaired physician behaviors.