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Showing results for tags 'Surgery - General'.
Found 485 results
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Content ArticleThis study by a team at the University of Derby in the British Journal of Anaesthesia used experimental psychology methods to explore the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a visual search task. The authors found that errors were detected faster when presented in the colour-coded compartmentalised trays than in conventional trays, a finding that was replicated for correct responses for error-absent trays. Overall, colour-coded compartmentalised trays were associated with significant performance improvements when compared with conventional trays.
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Content ArticleIt is difficult to monitor compliance to surgical checklists, which is associated with improved patient outcomes. This research study in The Annals of Surgery reported for the first time on the use of the Operating Room Black Box (ORBB) to track checklist compliance, engagement, and quality. The authors took a retrospective review of prospectively collected ORBB data and measures of checklist compliance, engagement and quality were assessed. ORBB provides the unprecedented ability to assess not only compliance with surgical safety checklists but also engagement and quality. This technology allows the assessment of compliance in near real time and to accurately address safety threats that may arise from noncompliance.
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Content ArticleThe original National Safety Standards for Invasive Procedures (NatSSIPs) were published in 2015. Understanding of how to deliver safe care in a complex and pressurised system is evolving. These revised standards (NatSSIPs2) are intended to share the learning and best practice to support multidisciplinary teams and organisations to deliver safer care.
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Content ArticleThis report considers the number of safety incidents in surgery occurring in the NHS since 2015 and calls for action to improve surgical safety. It also highlights the perceptions of patients from a survey of people who have had surgery in the last five years. It is authored by surgical care platform Proximie, with support from experts in the surgical space.
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Content ArticleThis article, published by MendWell, looks at the benefits of stopping smoking before surgery and the risks of continuing to do so. It includes tips on how to stop smoking.
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Content ArticleThe waiting list in England stood at more than seven million in September 2022, up by 1.2 million since September 2021 and 2.6 million since 2019. This analysis by the King's Fund outlines what different patients on the waiting list are waiting for, breaking this figure down into: different medical and surgical specialties whether patients are waiting for admission, diagnostics or decisions It highlights that many on the waiting list are awaiting further diagnostics or decisions before treatment can commence, and others are waiting for treatment that does not require admission to hospital.
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Content ArticleThis study in the Annals of Surgery aimed to characterise errors, events and distractions in the operating theatre, and measure the technical skills of surgeons in minimally invasive surgery practice. The authors of the study implemented the use of an operating room (OR) Black Box, a multiport data capture system that identifies intraoperative errors, events and distractions. The study found that the OR Black Box identified frequent intraoperative errors and events, variation in surgeons’ technical skills and a high number of environmental distractions during elective laparoscopic operations.
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Content ArticleA complaint from a patient was made to the Scottish Public Services Ombudsman (SPSO) about the care and treatment provided during the period January 2018 to September 2021. In January 2018 the patient underwent emergency surgery for a perforated sigmoid diverticulum (a complication of diverticulitis, an infection or inflammation of pouches that can form in the intestines). An emergency Hartmann's procedure (a surgical procedure for the removal of a section of the bowel and the formation of a stoma - an opening in the bowel) was performed. In April 2018, the patient was seen in an outpatient clinic and informed it would be possible to have a stoma reversal. The patient complained that the Board had continually delayed the stoma reversal surgery which they required, which as of September 2021 had not taken place. The patient also complained that Covid-19 could not account for the delays between the Board informing patient they were ready for surgery around December 2018 and the start of the pandemic in March 2020. The patient noted that as a consequence they had developed significant complications: a large hernia. The patient added that this had severely impacted their personal life and self-esteem, and left them unable to work and reliant on welfare benefits.
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News Article
Breast cancer patients in England face delays to reconstruction surgery
Patient Safety Learning posted a news article in News
Women waiting for breast reconstruction surgery on the NHS in England face a “postcode lottery” of care, with some forced to wait more than three years, a damning report warns. Two in five women (40%) waiting for breast reconstruction during the pandemic after having their breasts removed due to cancer faced a delay of 24 months or longer, according to research involving 1,246 women who either underwent reconstruction surgery or were waiting for it. The report by charity Breast Cancer Now also warned that some breast reconstruction services are still not operating at full capacity after temporarily pausing at the start of the Covid-19 pandemic. It says there was a 34% drop in breast reconstruction activity in England in 2021-22 compared with 2018-19. The charity added that on top of the delays, women face a “postcode lottery” of care, with some women offered certain types of reconstruction while others are denied the same operation. Breast Cancer Now called on NHS England to develop a plan to address the backlog of breast reconstruction services. One woman told the authors of the report she waited for three and a half years for breast reconstruction surgery, while another said she “wants to move on with my life” but has no idea when her surgery will go ahead. Baroness Delyth Morgan, the chief executive of Breast Cancer Now, said: “For women who choose breast reconstruction, it is a core component of their recovery – far from a solely aesthetic choice, this is the reconstruction of their body and indeed their identity after they have been unravelled by breast cancer treatment and surgery. “We hear of patients affected by delays to reconstruction surgery and the significant emotional impact this has on them, including altered body confidence, loss of self-esteem and identity, anxiety and depression, and hindering their ability to move forward with their lives, knowing their treatment is incomplete." Read full story Source: The Guardian, 19 October 2022 -
News Article
New research collaboration to improve patient safety
Patient Safety Learning posted a news article in News
University College London Hospitals (UCLH) is to host to a new collaboration researching patient safety, after being awarded £3 million in funding from the National Institute for Health and Care Research. The NIHR Central London Patient Safety Research Collaboration (PSRC) aims to improve safety in Surgical, Perioperative, Acute and Critical care (SPACE) services, which treat more than 25 million NHS patients annually. Perioperative care is care given at and around the time of surgery. Amongst the highest risk clinical settings are SPACE services because of the seriousness of the patients’ conditions and the complex nature of clinical decision making. Further risks arise at the transitions of care between SPACE services and other parts of the health and social care system. The research team led by UCLH and UCL will develop and evaluate new treatments and care pathways for SPACE services. This will include new interventions such as surgical and anaesthetic techniques, and new approaches to predicting and detecting patient deterioration. They will also help the NHS become safer for patients through the development of innovative approaches to organisational learning, and to how clinical evidence is generated. The PSRC’s learning academy will support the next generation of patient safety researchers through a comprehensive programme of funding, mentoring and peer support. The team includes frontline clinicians, policy makers and world-leading academics across a range of scientific disciplines including social and data science, mechanical and software engineering. Patients and the public representing diverse backgrounds are key partners in the collaboration. Professor Moonesinghe said: “We have a great multidisciplinary, multiprofessional team ready to deliver a truly innovative programme to improve patient safety in these high-risk clinical areas. As a uniquely rich research environment, UCLH and UCL are well placed to lead this work, and we are looking forward to collaborating with clinicians and patients across the country to ensure impact for the whole population which the NHS serves.” -
News Article
NHS doing fewer operations as theatres go unused
Patient Safety Learning posted a news article in News
The push to tackle the hospital backlog is being undermined by the struggle to get services back to full strength. A BBC analysis shows the expected surge in new patients has not yet happened. Instead, the waiting list in England is growing because the NHS is carrying out fewer operations and treatments than it was before Covid, despite a government push to boost capacity. Surgeons said it was really frustrating as operating theatres were not being used due to a lack of beds and staff. They say it is not unusual to find surgery cancelled at the last minute as staff are unavailable or intensive care and ward beds are full with other patients. "It's tough on patients and tough on staff who want to get on and treat patients," said Tim Mitchell, vice-president of the Royal College of Surgeons of England. "Without treatment, the health of patients can deteriorate. Not only do we need to get back to where we were before the pandemic, we need to do more if we are going to tackle the backlog." Read full story Source: BBC News, 13 October 2022 -
News Article
NHS declares first-ever ‘amber alert’ over critically low blood supplies
Patient Safety Learning posted a news article in News
The NHS has declared its first-ever amber alert over blood supplies, which have fallen to critically low levels. The alert means some non-urgent operations that require blood are likely to be impacted, with hospitals advised to swap in other surgeries which do not require blood. A letter is due to go out to hospitals on Wednesday, The Independent was told. Hospitals will be asked to make individual decisions over whether to postpone surgeries such as hip replacements but will continue to carry out urgent surgeries and blood transfusions for those with long term conditions. The “amber-alert” will last for four weeks initially, NHS Blood and Transplant has said. Wendy Clark, interim chief of NHS Blood and Transplant said: “Asking hospitals to limit their use of blood is not a step we take lightly. This is a vital measure to protect patients who need blood the most. “Patients are our focus. I sincerely apologise to those patients who may see their surgery postponed because of this." “With the support of hospitals and the measures we are taking to scale up collection capacity, we hope to be able to build stocks back to a more sustainable footing." Read full story Source: The Independent, 12 October 2022 -
News ArticleSurgical blunders have soared 60% in five years – and extreme mistakes are now a daily occurrence in the NHS. Some 13,921 people were treated for damage caused by botched operations in the year to March 31 – up from 8,695 in England in 2016/17. Cases involved an “unintentional cut, puncture, perforation or haemorrhage”. Separately, a report from NHS England shows 134 patients fell victim to so-called Never Events from April 1 to July 31. Extreme errors included two women left infertile after their ovaries were wrongly removed. Injections and invasive tests were given to the wrong patients and in 39 cases foreign objects, such as drill bits and wires, were left inside bodies. There were 57 cases of surgery on the wrong body part and 12 instances of patients being given the wrong implant or prosthesis. The Royal College of Surgeons in England said: “If the system is overstretched, there is a risk that mistakes will happen.” Rachel Power, chief executive of the Patients Association, said: “When Never Events occur, the physical and psychological effects can stay with a patient for life.” Read full story Source: The Mirror, 1 October 2022
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Content ArticleThe Operating Room Black Box (OR Black Box) is a system that collects, stores and analyses a large amount of data from the operating room beyond just surgical video, such as video and audio of the operating room and patient physiology data. In this episode of the Behind the Knife podcast, Dr. Teodor Grantcharov, one of the creators of the OR Black Box, talks about how the technology can be used to enhance surgical training. Using the system for feedback through self-directed review, coaching and integrated AI analysis has changed the way we can learn and teach in surgery, and may have implications for the future of evaluation and assessing credentials.
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Content ArticleStandard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. Morgan et al. evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs. They found that SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change.
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Content ArticleThe African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality rate twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. This aim of this study in The British Journal of Anaesthesia was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was developed using data from 8799 patients in 168 African hospitals. It includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The authors concluded that the ASOS Surgical Risk Calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance.
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Content ArticleThe objective of this study from Sharma et al. was to evaluate the accuracy of a new elective surgery clinical decision support system, the ‘Patient Tacking List’ (PTL) tool (C2-Ai(c)) through receiver operating characteristic (ROC) analysis. They found that the PTL tool was successfully integrated into existing data infrastructures, allowing real-time clinical decision support and a low barrier to implementation. ROC analysis demonstrated a high level of accuracy to predict the risk of mortality and complications after elective surgery. As such, it may be a valuable adjunct in prioritising patients on surgical waiting lists. Health systems, such as the NHS in England, must look at innovative methods to prioritise patients awaiting surgery in order to best use limited resources. Clinical decision support tools, such as the PTL tool, can improve prioritisation and thus positively impact clinical care and patient outcomes.
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Content ArticleThe number of patients who die from post-surgical complications in low- and middle-income countries is shockingly high. In Africa alone, more than 600,000 people die each year after surgery, mostly from causes that are relatively easy to treat. This blog by Pierre Barker, Chief Scientific Officer at the Institute for Healthcare Improvement (IHI) looks at a method for reducing post-surgical death called the '5Rs for rescue': Risk stratification Recognise deterioration Respond Reassess Reflect/Redesign He describes how the IHI will test how to support the reliable implementation of the '5Rs for Rescue', which aims to reduce mortality by 25%.
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Content ArticleThis NatSSIPs 8 flow chart illustrates the sequential standards in the National Safety Standards for Invasive Procedures 2 combined with the World Health Organization (WHO) surgical safety checklist.
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Content ArticleThe Operating Room Black Box, a system of sensors and software, is being used in operating rooms in 24 hospitals in the US, Canada and Western Europe. The device captures video, audio, patient vital signs and data from surgical devices in an effort to improve patient safety. This article in the Wall Street Journal looks at how Black Box technology at Duke University Hospital has identified several areas for improvement, including that the hospital needed a better system for sending and tracking specimens. The article also highlights some concerns raised by healthcare professionals about the use of Black Boxes, including fear that data collected might be used to punish staff, or that it may be used as evidence in medicolegal cases outside of hospitals' control.
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Content ArticleMaria Koijck's goal for this film was to create a movement within the pharmaceutical industry considering the waste it produces. In this film you see Maria lay in the middle of an incredible amount of waste from just one surgery, her surgery. In August 2019 Maria was diagnosed with breast cancer. Surgeons had to remove her entire left breast. After a successful recovery, she went to to have a deep lap surgery where they gave her an entire new breast of her own bodily materials. During this process she discovered that 60% of the surgery materials used for this operation is disposable. For example: the stainless steal scissors that are flown in from Japan, are used for one cut before they end up in the bin. Maria asked the doctors to collect all of the surgery materials used for her operation, to get a clear idea of how much it really was. She was shocked to see six bags full of plastic waste.
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Content Article
The IPP (Innovation, People and Practice) magazine
Patient Safety Learning posted an article in Surgery
Published 10 times a year by the Association for Perioperative Practice, the IPP covers a variety of topics relevant for perioperative practitioners. Ranging from news and information, special focus pieces, industry interviews and profiles of company leaders in an easy-to-read format. -
Content ArticleThis article, originally published in HindSight magazine, details a conversation between Steven Shorrock and with Manoj Kumar, consultant general surgeon with a background also in safety, human factors, and training. Manoj provides insights and perspectives on the realities of work in healthcare, and the team’s role in improvement.
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Content ArticleThis systematic review in the British Journal of Surgery aimed to describe types of cognitive bias in surgery, their impact on surgical performance and patient outcomes, their source, and the mitigation strategies used to reduce their effect. The authors concluded that cognitive biases have a negative impact on surgical performance and patient outcomes across all points of surgical care. This review highlights the scarcity of research investigating the sources that give rise to cognitive biases in surgery and the mitigation strategies that target these factors.
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Content ArticleIn this report, the Public Accounts Committee, which examines the value for money of UK Government projects, programmes and service delivery, looks in detail at the implementation of NHS England’s three-year recovery programme for tackling the Covid-19 backlog of elective care.
