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Content ArticleSmart digital technologies are rapidly transforming perioperative care through tools such as clinical decision support systems, wearable sensors, and electronic checklists. Despite growing adoption, their specific impact on patient safety in the operating room remains insufficiently understood. This narrative review, published in the journal Patient Safety in Surgery, explores recent advancements in perioperative digital health and examines how innovations like AI-assisted systems, electronic WHO checklists, and physiological monitoring wearables contribute to safer surgical care. The evidence suggests that these tools can enhance complication detection, protocol adherence, and team communication. However, their effectiveness is tempered by challenges including alert fatigue, fragmented data systems, and added digital workload for healthcare staff.
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News Article
AI outperforms surgeons in writing post-op reports
Patient Safety Learning posted a news article in News
A study has demonstrated that AI can create more accurate operative reports than surgeons. Published in the Journal of the American College of Surgeons, it is the first report on fully automated, video-based AI surgical documentation. The research highlights the potential of AI-driven solutions to reduce administrative burdens and improve surgical documentation. Surgeons frequently regard the creation of operative reports as essential yet time-consuming. These reports are inevitably subjective and may contain inaccuracies or incomplete information. The administrative task of documentation has also been recognised as a potential factor in physician burnout. Recent advancements in AI, especially in computer vision, have allowed automated systems to accurately detect surgical steps from video footage. Researchers aimed to create a platform that automates the generation of video-based AI surgical operative reports for robotic-assisted radical prostatectomy (RARP). Using an AI-powered algorithm, surgical steps were automatically identified in video recordings and mapped to pre-specified text to generate narrative AI operative reports. The accuracy of these AI-generated reports was then compared to traditional surgeon-written reports using an expert review of raw surgical video footage as the gold standard. The findings suggest that AI-driven operative reporting can enhance accuracy, reduce the documentation burden, and improve transparency in surgical procedures. Read full story Source: Surgery News, 24 March 2025 -
News Article
Don’t get surgery on a Friday
Patient Safety Learning posted a news article in News
If you have any say, you might want to avoid scheduling your next surgery on a Friday. The most comprehensive analysis of what happens to patients who have surgery on Fridays versus Mondays, published in JAMA by more than a dozen US and Canadian researchers, is unequivocal: The people who underwent all kinds of procedures before the weekend suffered on average more short-term, medium-term, and long-term complications than people who went under the knife after the weekend was over. The study was based in Ontario and included more than 450,000 patients who received one of the 25 most common surgeries between 2007 and 2019. Previous studies have generally found the same effects across different types of health systems: One UK-based study had reported better outcomes for Monday surgeries after 30 days. A paper looking at Dutch patients detected higher mortality rates after one month for patients who had Friday surgeries compared to Monday. This appears to be a phenomenon no matter the country, as prior US-based research also attests. People who received pre-weekend surgeries — defined as a Friday or a Thursday before a long weekend — were overall about 5% more likely to experience one of those complications within a year of their surgery than people who got post-weekend procedures (on Monday or the Tuesday after a long weekend). The effect was stronger for heart and vascular surgeries; it was negligible for obstetric and plastic surgeries. Researchers found Friday surgeries were more likely to be performed by junior surgeons when compared to Monday surgeries. “This difference in expertise may play a role in the observed differences in outcomes,” they wrote, based on a statistical analysis that controlled for other factors. There could also be fewer senior colleagues on the hospital campus for the junior physicians to consult with, the authors said. In addition, the weekend doctors and nurses may be less familiar with the patient’s case, raising the risk that complications will be caught later and therefore lead to worse outcomes. Read full story Source: Vox, 21 March 2025 -
Content ArticleRemote digital postoperative wound monitoring provides an opportunity to strengthen postoperative community care and minimise the burden of surgical-site infection (SSI). This study aimed to pilot a remote digital postoperative wound monitoring service and evaluate the readiness for implementation in routine clinical practice. It concluded that remote digital postoperative wound monitoring successfully demonstrated readiness for implementation with regards to the technology, usability, and healthcare process improvement.
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EventuntilJoin BD this live educational event designed to promote discussions on the following topics: An overview of the latest evidence-based prevention measures of HAI (SSI). Essential bundles of an effective infection prevention and control program management in cardiac surgery. Review of the sustainable change in practice within operating room. The event is designed for cardiac surgeons, infection control and nurses who are interested in learning more about new techniques and methodologies to minimise some of the most challenging post-operative complications, with an opportunity to debate and share opinions with peers through live discussions with internationally renowned faculty. Register
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News ArticlePatients who receive good perioperative care can have fewer complications after surgery, shorter hospital stays, and quicker recovery times, shows a large review of research. The Centre for Perioperative Care, a partnership between the Royal College of Anaesthetists, other medical and nursing royal colleges, and NHS England, reviewed 27 382 articles published between 2000 and 2020 to understand the evidence about perioperative care, eventually focusing on 348 suitable studies. An estimated 10 million or so people have surgery in the NHS in the UK each year, with elective surgery costing £16bn a year. A perioperative approach can increase how prepared and empowered people feel before and after surgery. This can reduce complications and the amount of time that people stay in hospital after surgery, meaning that people feel better sooner and are able to resume their day-to-day life. Read full story (paywalled) Source: BMJ, 17 September 2020
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Content ArticleThis guide from the Patient Safety Movement Foundation gives actions and resources for creating and sustaining safe practices for surgical site infections.
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Content Article
Prevention of Future Deaths Report – Gary Day
PatientSafetyLearning Team posted an article in Coroner reports
Gary Day had a choroidal melanoma of the left eye. After discussing his treatment options with clinicians at Moorfields Eye Hospital, he elected to have that melanoma removed by an endoresection procedure at the hospital. Gary Day died less than 24 hours after the operation as a result of an air embolism. In the Coroner’s matters of concern, it was noted he was not advised beforehand of the potential risk of death, there was no check for an air embolism after the operation and he probably should have been kept in hospital overnight for observation. The report was sent to Moorfields Eye Hospital but has safety implications for all Trusts performing this procedure. Evidence showed that: 1. Mr Day was not informed that there was any risk of death from the surgery he elected to have, even though there is a risk of air embolus, and therefore death, from this procedure. The Consent Form he signed did not make any reference to a risk of death. 2. There was no check carried out for air embolus after the operation. 3. There was confusion between medical staff as to whether or not Mr Day was to be kept in for an over-night stay in hospital. As it turned out, he was not advised to stay in hospital over-night. 3 Mr Day was allowed to leave 3 hours after the operation had concluded. This meant that when he was taken to the Royal London Hospital on the evening of the 15th December, 2020 clinical staff in hospital did not have immediate access to any medical notes concerning his earlier procedure. The Assistant Coroner listed his concerns and recommendations as follows: (a) Any patient who elects to have an endoresection operation of an choroidal melanoma faces a risk (however small) of air embolism and therefore death. This must be made clear to all patients undergoing such a procedure. (b) There ought to be some check/investigation post operation to determine (or to try and determine as best possible) whether air may have entered the blood stream during the operative procedure. (c) Patients undergoing this operation (which normally lasts between 2-3 hours) should be advised to stay in hospital as an in-patient for at least 24 hours, which would enable careful and extended monitoring of their condition and a swift and informed transfer, if necessary, to an acute care unit of a hospital in the event of a deterioration in their condition. -
Content ArticleGetting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings. Anaesthesia is the largest hospital speciality in the UK, involved in a third of all hospital admissions, while perioperative care covers a patient's care from when they first contemplate surgery to their full recovery. The GIRFT national report for anaesthesia and perioperative medicine contains 18 recommendations based on information gathered from the 134 trusts in England with an anaesthesia and perioperative medicine service. It seeks to improve outcomes for patients having surgery in the new COVID-19 environment, including reducing the amount of time they spend in hospital. You will need a FutureNHS account to view this report, or you can watch a short video summary summarising key recommendations.
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Content ArticleToday was the Parliamentary launch event of the Surgical Fires Expert Working Group’s report, 'A case for the prevention and management of surgical fires in the UK', which focuses on the prevention of surgical fires in the NHS This report contains important information on surgical fires and their prevention, to be submitted to the Centre for Perioperative Care (CPOC), in order to make the case for its inclusion on their agenda. In the perioperative setting, a fire may cause injury to both the patient and healthcare professionals. Injuries caused by a surgical fire most commonly occur on the head, face, neck and upper chest. The prevention of surgical fires, which can occur on or in a patient while in the operating theatre, is an urgent and serious patient safety issue in UK hospitals. A Short Life Working Group (SLWG) for the prevention of surgical fires was established in May 2019, following an initial discussion in December 2018 on the issue of surgical fires in the UK. The group of experts from healthcare organisations and bodies across the UK convened four times in 2019 with the aim of compiling this document, in order to recommend surgical fires for a Never Event classification. The group conducted a literature review of best practice and evidence, in the UK and internationally, which informed the development of a number of considerations that could address the issue of surgical fires. This report contains information surrounding the scale of the problem of surgical fires in the UK, in addition to reported experiences of these incidences by both healthcare professionals and patients. It also includes prevention and management materials, and mandatory training that should be consistently delivered to hospital staff, and concludes with recommendations moving forward, in order to ensure the prevention of surgical fires in UK hospitals.
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Content ArticlePete Smith is nothing without the energy and commitment of the amazing people who surround him. Increasing the technical skill of a healthcare clinician makes for incremental change. Improve the culture within which they work, think and communicate and suddenly quantum change is possible. Two perioperative nurses from a regional hospital in Victoria, Australia, innovated a simple, elegant solution to the problem of noise and distraction in the operating room. Pete Smith was one of them.
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Content ArticleThe Care Quality Commission (CGC) is the independent regulator of health and adult social care in England. They make sure that health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve. Independent acute hospitals play an important role in delivering healthcare services in England, providing a range of services, including surgery, diagnostics and medical care. As the independent regulator, the CQC, hold all providers of healthcare to the same standards, regardless of how they are funded. In this report the CQC have seen much good and outstanding care, in particular around: responsiveness staff interactions with patients effective treatment leadership and engagement with staff and patients. However, there were a number of areas where services needed to make substantial improvements: governance clinical audit safety culture.
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Content ArticleThis report, by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) looks at the peri-operative mortality rate in the UK and argues that people die because we do not give them the level of care they are entitled to expect. In this report less than half of the high-risk patients received care that the expert advisors thought they would accept from themselves or their own institutions. Th reasons for this are examined within the report.
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Content ArticlePostoperative delirium is common and has multiple adverse consequences. Guidelines recommend routine screening for postoperative delirium beginning in the post-anaesthesia care unit. The 4 A’s test (4AT) is a widely used assessment tool for delirium; however, there are no studies evaluating its use in the post-anaesthesia care unit. Saller et al. evaluated the performance of the 4AT in the post-anaesthesia care unit in a tertiary German medical centre. The findings published in Anaesthesia suggest that the 4AT is an effective and robust instrument for delirium detection in the post-anaesthesia care unit. suggest that the 4AT is an effective and robust instrument for delirium detection in the post-anaesthesia care unit.
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Content Article
Patient information for surgical safety: WHO leaflet (2015)
Claire Cox posted an article in Keeping patients safe
This leaflet produced by the World Health Organization (WHO) is aimed at patients who are undergoing a surgical procedure. It aims to enable communication between you and your surgical team, including you in safety checks. -
Content ArticleMaintaining safe elective surgical activity during the global coronavirus disease 2019 (COVID‐19) pandemic is challenging and it is not clear how COVID‐19 may impact peri‐operative morbidity and mortality in this population. Therefore, adaptations to normal care pathways are required. Here, Kane et al. establish if implementation of a bespoke peri‐operative care bundle for urgent elective surgery during a pandemic surge period can deliver a low COVID‐19‐associated complication profile. Kane et al. present a single‐centre retrospective cohort study from a tertiary care hospital of patients planned for urgent elective surgery during the initial COVID‐19 surge in the UK between 29 March and 12 June 2020.
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Content ArticleThis project aims to develop peer consensus centred on specific themes defined by the steering group covering topics relevant to the optimal, universal and evidence-based care bundle to reduce surgical site infections (SSIs). It will support building expert consensus around best practices when selecting the care bundle to reduce surgical site infections in practice. It is hoped that the output will support best practice patient management in Europe. The survey takes under 10 minutes to complete. Please review each statement and indicate your level of agreement with it (tick one box only per statement). Please only complete this questionnaire once. Your anonymous responses will be a source of data for the development of a consensus publication. This project has been initiated and funded by Becton Dickinson and is being managed and delivered by Triducive.
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News ArticleThe parents of a one-year-old girl who died after 'gross neglect' have called the mistakes made at a hospital where she was being cared for 'unbelievable'. Eleanor Aldred-Owen, from Mold, was diagnosed with bicoronal craniosynostosis at just 12 weeks old. This condition meant that the sutures, the fibrous tissue joints connecting the bones of the skull, had fused prematurely, preventing normal growth and necessitating surgery to alleviate potential pressure on her brain. An inquest into Eleanor's death held at Gerard Majella Coroner's Courthouse in Liverpool on Wednesday (December 18) heard how Eleanor attended Alder Hey Children's Hospital in Liverpool for surgery on September 29 2023, but complications arose and the hospital missed crucial opportunities to address them. Eleanor’s parents Rachel and Chaz have now issued a heartbreaking statement following the inquest saying their lives are "empty and quiet" without their daughter. "We have found the failings in care identified by the hospital and recognised by the Coroner as unbelievable. We thought Eleanor would be cared for by specialists, instead there were 24 identified lessons to be learned in relation to her post operative care. "The process of the Trust investigation was not an experience we found helpful and in particular we found the stance taken in preparation for the inquest and in the Trusts submissions to the Coroner only made this worse. "We are intensely grateful to the Coroner for her thorough investigation and her conclusion that Eleanor died as a result of numerous gross failures to provide her basic medical care, of course none of this changes the fact we have to continue our lives without Eleanor.” Read full story Source: Wales Online, 19 December 2024
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Community Post
National Safety Standards for Invasive Procedures
Annie Hunningher posted a topic in Surgery
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How are people getting on with the NatSSIPs? PDF version to share NatSSIPs headline booklet.pdf- Posted
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Content ArticleMesh implantation for hernia repair has become standard practice for the majority of hernia repairs. Mesh-based hernia repairs have been shown to be a durable solution, however, postoperative complications, such as chronic postoperative pain, remain a concern. To date, there have been few investigations into the inflammatory response to mesh. In this study, Fadaee et al. present their experience in diagnosing and treating a subpopulation of patients who require mesh removal due to a possible mesh implant illness. They found predisposing factors include female sex, history of autoimmune disorder, and multiple medical and environmental allergies and sensitivities. Presenting symptoms included spontaneous rashes, erythema and oedema over the area of implant, arthralgia, headaches and chronic fatigue. Long-term follow up after mesh removal confirmed resolution of symptoms after mesh removal. The authors hope this provides greater attention to patients who present with vague, non-specific but debilitating symptoms after mesh implantation.
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) is to help improve patient safety in relation to the care of patients who have NHS-funded surgery in an independent hospital. This was initiated in the context of the COVID-19 pandemic, where because of increased pressure on the NHS, independent hospitals have been providing more care for NHS patients, including urgent elective surgical care and delivery of cancer pathways. The HSIB investigation reviewed the experience of a patient with a diagnosis of bowel cancer, who was booked to undergo laparoscopic (keyhole) surgery to remove part of his bowel in in an independent hospital. Following surgery, the patient made slow progress and on day eight following surgery he started to deteriorate rapidly. He was transferred to the local NHS hospital for investigation and further surgery. He died later the same day as a result of sepsis following a complication of his recent surgery. The investigation explored: Safety issues associated with the establishment of surgical services in independent hospitals to support the NHS and in particular the specialist services that are in place to deliver patient care. The assessment of patients prior to surgery to identify their risk and suitability for an operation and where it was to be undertaken; this included identification of patients with frail physical states. Key findings included: National and local NHS organisations had limited understanding of independent hospitals’ capabilities. This resulted in variation in how independent hospitals were used during Covid-19. Some independent hospitals saw patients with increasingly complex conditions and undertook more complex operations during Covid-19. The increasing complexity was well managed where capability of the independent hospitals had been evaluated and addressed prior to implementation of new services. Where pathways between NHS and independent hospitals were effective, it was often found that relationships between the hospitals had been longstanding and direct. There was variation in how preoperative assessments were undertaken across NHS and independent hospitals. This included what tests were ordered and risk assessments undertaken. Preoperative nutrition screening was inconsistent across NHS and independent hospitals. Examples were identified where it was not undertaken, or undertaken too late to allow any preoperative optimisation – that is, to make sure the patient was in the best possible nutritional state before their operation. Remote preoperative assessment became the norm during Covid-19, but created risks when staff were not able to see the patient. Lack of video call facilities and staff preference meant assessments were commonly done by telephone. Safety recommendations HSIB recommends that NHS England and NHS Improvement ensures that effective processes have been implemented in integrated care systems to identify local capability and capacity of their independent acute hospitals. HSIB recommends that NHSX expands its work programme addressing the challenges associated with interoperability of information systems used in healthcare to include transfer of information between the NHS and independent sector in support of safe care delivery. HSIB recommends that the Care Quality Commission reviews and appropriately develops its methodology for regulatory assurance of arrangements between NHS and independent providers for the provision of care across care pathways. This is to include any screening and risk management processes used to ensure the safe transfer of care between providers. HSIB recommends that NHS England and NHS Improvement reviews models of perioperative care for their value and impact. This should inform future work to support implementation of a standardised approach, based on evidence, across all healthcare providers that deliver surgical services. HSIB recommends that NHS England and NHS Improvement establishes a process to ensure that findings of the National Institute for Health Research’s policy research programme into frailty in younger patient groups are reviewed and acted upon.
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Content Article
Centre for Perioperative Care newsletter
Patient Safety Learning posted an article in Health care
The CPOC Newsletter is for all doctors, nurses and allied health professionals working in or with an interest in the developments of perioperative care. The monthly publication highlights the most up to date information on the workstreams, partner projects, perioperative events, recently published journals, live surveys and successful perioperative initiatives. -
Content ArticleThis guide is for patients and carers (that is, someone who looks after someone else). It gives you suggestions that you can use to improve patient safety.
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Content ArticleSurgical wound management is critical to postoperative care, influencing patient recovery, infection control, and healthcare costs. Despite advances in surgical techniques, surgical site infections (SSIs) remain a concern, leading to increased morbidity and hospital stays. Standardised, evidence-based practices are essential for improving patient outcomes. This article in the British Journal of Nursing provides concise, evidence-based guidance on surgical wound management across the preoperative, perioperative, postoperative and discharge phases. It synthesises current guidelines and highlights emerging best practices for health professionals. Best practices require a multidisciplinary approach, strict infection prevention protocols, effective wound closure techniques, and patient education. Variability in clinical application persists, but early-stage innovative methods such as remote wound monitoring show promise in reducing hospital visits, detecting complications early and increasing patient satisfaction.
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Content Article
Centre for Perioperative Care: Explore our case studies
Patient Safety Learning posted an article in Surgery
The Centre for Perioperative Care have many case studies on their website on preoperative optimisation and assessment, older people undergoing surgery and hip fracture care. Preoperative optimisation Preoperative assessment Case Studies: Older people undergoing surgery Hip fracture care Postoperative phase
