Millions of people undergo surgery every year in the U.S. and with so many things that can go wrong this is often a very difficult decision for patients to make. The Centers for Disease Control and Prevention and Johns Hopkins School of Medicine report that there are 39 cases weekly of a surgeon leaving a foreign object such as a sponge or towel inside a patient’s body after an operation. They also found that every week, there are 20 cases where a surgeon performs the wrong procedure on a patient and 20 cases of surgeons operation on the wrong site. Additionally, they found that in 2013 there were 157,000 surgical-site infections. This is why so many patients are demanding change, and many hospitals are implementing better practices to make surgery safer.
The Wall Street Journal reports that many hospitals are participating in the National Surgical Quality Improvement Project (NSQIP), overseen by the American College of Surgeons and adapted from an effort at Veterans Administration hospitals that helped decrease postoperative deaths by 47 percent. NSQIP works with about 600 hospitals across the U.S. to gather and analyze data in order to provide hospitals with the resources and suggestions they need to help tackle safety gaps. The group estimates that if every U.S. hospital used the program, it could save 100,000 lives, prevent more than 2.5 million complications and reduce costs by more than $25 billion every year.
To test its efficacy, 10 hospitals in Tennessee called on NSQIP for help. Between 2009 and 2012, data was collected on more than 55,000 surgical procedures and 17 different types of surgical complications were examined. The result? The hospitals were able to implement changes the resulted in 20-percent fewer complications, saving 533 lives and $75.2 million in costs.
NSQIP identified 8 of the biggest safety and quality issues related to surgery and what hospitals can do to remedy them:
1.) Preoperative patient care: Reduce the use of narcotic painkillers to ease recovery, remove urinary catheters sooner, monitor surgical incision for infection, and delay elective procedures in patients who smoke, have diabetes, or are obese for weight loss, smoking cessation, and blood-sugar control.
2.) Surgical wound infections: Give patients antibiotics before surgery, clean the skin at the site of surgery with special soap that kills germs, have staff wear special hair covers, masks, gowns and gloves during surgery.
3.) Surgical objects left in patients: Staff should count instruments, needles and sponges before and after surgery, use radio-frequency ID tags to detect before closing wounds.
4.) Surgery on wrong patient or body part: Mark operative body part or site, staff should take a timeout before start of surgery to ensure accuracy, and empower all staff to halt procedure if in doubt.
5.) Operating room fires: Training programs and drills should be in place to prevent fires and react when they occur, fire extinguishers, and evacuation plans.
6.) Anesthesia complications: Assess patients for possible allergic reactions to certain drugs, screen for genetic susceptibility to adverse reaction to anesthesia.
7.) Blood clots: Assess a patient’s risk for blood clots traveling to lungs after surgery, administer blood thinners and get patients up and moving after surgery ASAP.
8.) Disruptive or threatening surgeon behavior: Anger-management programs for staff, professional-conduct committee, and loss of operating room privileges.
So far, three hospitals in Arizona have used NSQIP to help improve safety and quality measures: Mayo Clinic Arizona, Scottsdale Healthcare Osborn Medical Center & Greenbaum Surgical, and St. Joseph’s Hospital and Medical Center. For a list of hospitals across the U.S., visit NSQIP’s website by clicking here.
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