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Talk about surgical safety and people will automatically think of issues like objects left in a patient after closing or operating on the wrong site. Surgical-site infections are a hot topic. But surgical scheduling? Put that in the PubMed search engine and not much comes up. Add the term "patient safety" and you get a single, lonely article.
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There has been an intense focus on reducing unplanned readmissions in hospitals. Payers are refusing to pay for them, and increasingly the public believes that they are a determinant of the level of quality of care a particular facility provides to patients. But a study in the June issue of Health Affairs1 indicates that looking at this single data point doesn't tell the whole quality story.
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Checklists are often touted as the potential cure for the ill that is patient harm. If it works for the aerospace industry, why can't it work for healthcare? Indeed, there is ample evidence that some checklists can make a big difference in patient safety.
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Checklists and clear protocols for clinical care have been highly successful in infection prevention and other fields, but can be easily undercut by a simple non-action: silence.
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The broad misconception that infectious diseases were fading as a medical concern with the development of antibiotics and vaccines was dashed in dramatic and tragic fashion in 1981 when the first cases of a strange new illness were reported among groups of gay men in New York, Los Angeles and San Francisco. The AIDS epidemic had begun.
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The newly accredited MaGil IRB in Rockville, MD, has review process timelines that might seem impossible to other organizations, including a self-imposed deadline of four hours from the time an IRB review submission is made to the time it is seen by IRB members.
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For IRBs at mid-sized institutions, monthly meetings can go for hours and involve many protocols. This can be very time-consuming and cumbersome for IRB members and investigators alike. Protocol discussions may not get the time they need, and members simply may not have enough time to review all the agenda items.
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Human research protection offices have found that adopting policies and procedures regarding the reporting of unanticipated problems (UPs) has helped to reduce IRB busywork and improve the research communitys understanding of when to report problems, experts say.
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The IRB office at the University of Utah in Salt Lake City takes its standard operating procedures (SOPs) very seriously. The IRB even dedicates one highly experienced, part-time professional to make frequent revisions and improvements to the SOPs and guidance.
