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Search results for "Policies and Operations"
Journal Article > Commentary
Ubaldi K. AORN J. 2019;109:435-442.
Journal Article > Study
Sun E, Mello MM, Rishel CA, et al; Multicenter Perioperative Outcomes Group (MPOG). JAMA. 2019;321:762-772.
Scheduling overlapping surgeries has raised substantial patient safety concerns. However, research regarding the impact of concurrent surgery on patient outcomes has produced conflicting results. In this multicenter retrospective cohort study, researchers examined the relationship between overlapping surgery and mortality, postoperative complications, and surgery duration for 66,430 surgeries between January 2010 and May 2018. Although overlapping surgery was not significantly associated with an increase in mortality or complications overall, researchers did find a significant association between overlapping surgery and increased length of surgery. An accompanying editorial discusses the role of overlapping surgery in promoting the autonomy of those in surgical training and suggests that further research is needed to settle the debate regarding the impact of overlapping surgery on patient safety.
Journal Article > Study
A policy-based intervention for the reduction of communication breakdowns in inpatient surgical care: results from a Harvard surgical safety collaborative.
Arriaga AF, Elbardissi AW, Regenbogen SE, et al. Ann Surg. 2011;253:849-854.
Communication failures in the surgical setting are a known threat to patient safety and the second most common root cause of adverse events (following technical errors). This study implemented a set of tailored policy and education initiatives at 4 teaching hospitals in an effort to increase timely and consistent resident–attending communication and promote attending visits with surgical patients. Investigators analyzed more than 200 critical events and 1300 patient cases and noted significant improvements in communication between residents and attendings. The number of patients not visited by attendings on weekends decreased by half, and the improved communications resulted in attending-level changes in patient management a third of the time. An accompanying editorial [see link below] discusses the study's findings and emphasizes the importance of simply setting clear and explicit expectations for communication. A past AHRQ WebM&M perspective discusses surgical safety with this study's senior author, Dr. Atul Gawande.