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Ten steps for making surgery safer

Wrong-site surgery: 20 times a week. Wrong surgery on a patient: 20 times a week. Object left in a patient: nearly 40 times a week. Surgical "never events": more than 4,000 times a year. Those statistics were reported in a study published in April in the journal Surgery.1 With such statistics, there will never be a single solution that makes surgery safer.

You can use a time-out, too

Every parent of a toddler knows that a time-out isn't so much a punishment for the child as a moment to breathe for the parent. It's this moment of calm that is the basis for the use of time-outs in a variety of fields, including surgical medicine. It's a chance to stop and make sure the path you are on is correct. And it's a tool that anyone can use, says Vicki Hess, RN, MS, principle at Catalyst Consulting, based in Baltimore, MD.

The scheduling/safety intersect

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.

Better metrics needed to determine quality

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.

Studies show limits of surgical checklists

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.

Virtual IRB has quick turnaround for reviews

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.

For one IRB, splitting up is easy to do

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.

Better understanding of UPs leads to fewer unnecessary IRB reports

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.

Best Practices Spotlight: Create lean, efficient, compliant SOPs

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.

UCLA’s guidance for UPs provides best practice model

The University of California Los Angeles (UCLA) recently updated its guidance on reporting unanticipated problems (UPs), adverse events (AEs), and other incidents in human subject research, providing a model for IRBs.