NSQIP – Why These Five Letters May Make Surgery a Safer Experience
By Dr. Kenneth Rothaus
The National Surgical Quality Improvement Project, in cooperation with approximately 600 hospitals, collects and analyzes their individual data, compares it to other hospitals, and helps hospitals find and plug the gaps in their safety net.
An article in Health Care, a section of the Wall Street Journal, reviews some of the most common areas of safety concern for the surgical patient, and what can be done to improve them. A list of these areas and the associated safety measures follows:
- Preoperative Patient Care: – Stop smoking, get diabetes under control
- Wrong Side Surgery – Mark operative site, Pre-Surgery time out
- Blood Clots – Compression Stockings, Early Walking, Blood Thinners
- Surgical Wound Infections – Appropriate Use of Antibiotics and Sterile Technique
- Operating Room Fires – Training Programs in Fire Prevention and Drills on how to react to operating room fires
- Disruptive Staff Behavior – Anger Management, Better Reporting Systems, Loss of Privileges
- Objects left in Patient – RF ID tags to identify sponges
- Anesthesia Complications – Screen for allergies and familial susceptibility to reactions to certain anesthetics
- Post-operative Care – Early removal of urinary catheters, Reduce use of Narcotics
Most, if not all, of these safety measures have been incorporated in the culture of patient safety that exist at the hospitals where my co-author and I are attending. Clearly, there is an element of risk that can never be eliminated in surgery; however, attention to safety measures as listed above will, hopefully, bring those numbers as close to zero as possible.
Do you trust your hospital’s safety net? Are you safe in the knowledge that they won’t include any of these mistakes in your history file?
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