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Showing results for tags 'Post-op period'.
Found 42 results
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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 -
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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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 -
Content ArticlePatients have better outcomes with female surgeons, a study from Wallis et al. has found. In a cohort study of 1 million patients, those treated by a female surgeon were less likely to experience death, hospital readmission, or major medical complication at 90 days or 1 year after surgery. This association was seen across nearly all subgroups defined by patient, surgeon, hospital, and procedure characteristics. The analysis, reported in Jama Surgery, showed that 90 days after an operation, 13.9% of patients treated by a male surgeon had “adverse post-operative events”, a catch-all term that includes death and medical complications ranging from problems that require further surgery to major infections, heart attacks and strokes. The equivalent figure for patients seen by female surgeons was 12.5%. Patients seen by female surgeons fared better one year after surgery too, with 20.7% having an adverse postoperative event, compared with 25% of those seen by male surgeons. When the doctors looked purely at deaths post-surgery, the difference was even starker: patients treated by male surgeons were 25% more likely to die one year after surgery than those treated by female surgeons. A second study of 150,000 patients in Sweden, also published in Jama Surgery, paints a similar picture. Dr My Blohm and colleagues at the Karolinska Institute in Stockholm reviewed patient outcomes after surgery to remove the gallbladder. They found that patients treated by female surgeons suffered fewer complications and had shorter hospital stays than those treated by men. The female surgeons operated more slowly than their male colleagues and were less likely to switch from keyhole to open surgery during an operation.
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Content ArticlePeri-operative medication safety is complex. Avoidance of medication errors is both system- and practitioner-based, and many departments within the hospital contribute to safe and effective systems. For the individual anaesthetist, drawing up, labelling and then the correct administration of medications are key components in a patient's peri-operative journey. These guidelines from the Association of Anaesthetists aim to provide pragmatic safety steps for the practitioner and other individuals within the operative environment, as well as short- to long-term goals for development of a collaborative approach to reducing errors.
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Content Article
Surgical Voices podcasts
Patient Safety Learning posted an article in Surgery
A series of podcasts from Molnlycke UK, with host Steve Feast, discussing topics such as sustainability, patient safety and more. Episodes: Sustainability in the operating theatre - guest speakers Tod Brindle, Molnlycke Medical Director, and Toby Cobbledick, Molnlycke Sustainability Specialist. Preventing surgical site infections: pre-surgery - guest speaker Lindsay Keeley, Patient Safety and Quality Lead AfPP. Preventing surgical site infections: post-surgery - guest speaker Lindsay Keeley, Patient Safety and Quality Lead AfPP. Supporting patients in their recovery from surgery - guest speaker Helen Hughes - Chief Executive of Patient Safety Learning. -
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 ArticleThe Perioperative Warming Quality Improvement Resource summarises the evidence for temperature monitoring, pre, intra and post-operative warming, plus intravenous and irrigation fluids. See also the Perioperative Warming Decision Guide to help support what pre, intra and post-op actions need to be taken to prevent inadvertant perioperative hypothermia.
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Content ArticleThe Surgical Skin Preparation Quality Improvement Resource summarises the evidence for patient washing, hair removal, skin disinfection and the use of incise drapes.
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Content ArticleThe Centre for Perioperative Care (CPOC) has started work on the UK’s first ever Green Paper on perioperative care. The Green Paper project is a nine-month programme of consultation and research about how to advance the perioperative care agenda. It aims to draw CPOC’s diverse community of partners together around a shared set of priorities for change and a vision for the future. The project will draw on a wide evidence base, building on work already happening within CPOC, our partner organisations and across the entire health and care sector. We will also reach out to our community of thousands of health professionals and patients to generate new evidence that will enable us to develop future policy and make the best possible case for change. Get involved The Green Paper can't be delivered without the active participation and help of everyone working to deliver better patient-centred care. If you would like to get involved with this project, then please consider joining the informal ‘sounding board’ of healthcare professionals, patients, and policymakers. The kinds of things CPOC will be looking for your help with include: Giving your views as CPOC develop their policy thinking, e.g. by taking surveys, feeding back on draft papers or reports, testing the messaging, and helping plug evidence gaps or prioritise what CPOC explore further. Championing the work on social media and to your personal and professional networks. Blogging for CPOC to share your experiences, reflecting on new findings, and informing the public about this work. Attending workshops or events CPOC may host as part of the consultation work for this project. If interested email [email protected].
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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 ArticlePrevious research suggests that surgical safety checklists (SSCs) are associated with reductions in postoperative morbidity and mortality as well as improvement in teamwork and communication. These findings stem from evaluations of individual or small groups of hospitals. Studies with more hospitals have assessed the relationship of checklists with teamwork at a single point in time. The objective of this study from Molina et al. was to evaluate the impact of a large-scale implementation of SSCs on staff perceptions of perioperative safety in the operating room. They concluded that a large-scale initiative to implement SSCs is associated with improved staff perceptions of mutual respect, clinical leadership, assertiveness on behalf of safety, team coordination and communication, safe practice, and perceived checklist outcomes.
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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 ArticleA group of clinicians and patient group representatives, called the ImPrOve Think Tank, recently convened to address common complication during high-risk surgery they consider to be most urgent and dangerous; haemodynamic instability characterised as significant drops in blood pressure. In this article for The Parliament Magazine, Professor Olivier Huet, Sean Kelly MEP and Ms Luciana Valente discuss why death rates are so high in the 30 days post-surgery, what clinicians can do to improve patient safety and what patients can do to ensure optimal patient safety and care in the perioperative process.
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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 Article
Centre for Perioperative Care: What is perioperative care?
Patient Safety Learning posted an article in Surgery
Perioperative care is the Integrated care across the full patient pathway before, during and after surgery. Perioperative care, also referred to as perioperative medicine, is the practice of patient-centered, multidisciplinary, and integrated medical care of patients from the moment of contemplation of surgery until full recovery. The Centre for Perioperative Care has produced a video on what good perioperative care looks like and a number or resources and advice on the perioperative journey. -
Content Article
Perioperative care – The ‘Holy Grail of healthcare’
Patient Safety Learning posted an article in Surgery
The Centre for Perioperative Care (CPOC) has now published, perhaps for the first time on this scale, comprehensive evidence that the perioperative pathway is associated with higher quality clinical outcomes, reduced financial cost and better satisfaction for surgical patients. This triad is the holy grail of healthcare. Dr David Selwyn, Director of the Centre for Perioperative Care, and Mr Mark Weiss, Head of Policy and Public Affairs, Royal College of Anaesthetists have written this blog in line with CPOC's own rapid research review that highlights the impact of perioperative care and their pioneering new evidence. "Now is the time to ensure that every surgical patient’s journey is delivered along a single, coordinated care pathway, supported by an appropriate multi-professional team. Now is the time to deliver seamless communication and collaboration between primary, secondary and community care. Now is the time to review our patient flows and how we counsel and prepare patients for surgery. And now is the time to empower patients through shared decision-making and personalised care, and to change the postoperative course with emphasis on enhanced recovery. " -
Content ArticleThis review explores the benefits of multidisciplinary team working to support people having surgery and the factors that may help and hinder its development and sustainability. Perioperative care is the integrated multidisciplinary care of patients from the moment surgery is contemplated through to full recovery. Multidisciplinary working, whereby professionals from different specialties and sectors work together to support someone along their journey, is a foundation of perioperative care. The Centre for Perioperative Care (CPOC) wanted to explore the benefits of, and barriers and enabler to, multidisciplinary team working. The rapid review summarises learning from 236 UK and international studies about this. About 13% of the studies were from the UK. To identify relevant research, 14 bibliographic databases were searched and screened more than 18,000 articles available as of June 2020. This report teases out the ‘ingredients’ for successful team working at system, organisational, team and individual level. In the COVID-era, multidisciplinary perioperative teams can be at the front and centre of supporting staff to deliver the best possible care. Key messages Our review found that multidisciplinary working is worth prioritising. There is evidence that in some cases multidisciplinary working can: speed access to surgery, if that is an appropriate treatment option improve people’s clinical outcomes, such as reducing complications after surgery reduce the cost of surgical care by helping people leave hospital earlier However, these benefits are not always apparent. More work is needed to explore which types of multidisciplinary working are most effective and what infrastructure and resources are needed to strengthen and sustain multidisciplinary care around the time of surgery.
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Content ArticleThis report from the Centre for Perioperative Care provides evidence to justify the case for perioperative care, the integrated multidisciplinary care of patients from the moment surgery is contemplated through to full recovery. This report has brought together a wide range of research about the effectiveness of perioperative care. It considered over 27,000 studies in preparing this review. The results show that perioperative care is associated with high quality clinical outcomes, reduced financial cost and better patient satisfaction. 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. The review highlights the effectiveness of clear perioperative pathways, with an average two-day reduction in hospital stay across multiple types of surgery. Different interventions, including prehabilitation, exercise and smoking cessation can significantly reduce complications by 30% to 80%. This scale of benefits is far greater than many new drugs or treatments launched.
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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.
