Critical Roles of Orthopaedic Surgeon Leadership in Healthcare Systems to Improve Orthopaedic Surgical Patient Safety
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Clin Orthop Relat Res (2013) 471:1792–1800 DOI 10.1007/s11999-012-2719-3
A Publication of The Association of Bone and Joint Surgeons®
SYMPOSIUM: ALIGNING PHYSICIAN AND HOSPITAL INCENTIVES
Critical Roles of Orthopaedic Surgeon Leadership in Healthcare Systems to Improve Orthopaedic Surgical Patient Safety Calvin C. Kuo MD, William J. Robb III MD
Published online: 6 December 2012 Ó The Association of Bone and Joint Surgeons1 2012
Abstract Background The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. Questions/purposes We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. This work was performed at NorthShore University HealthSystem, Evanston, IL, USA. C. C. Kuo San Francisco Orthopaedic Residency Program, St Mary’s Medical Center, San Francisco, CA, USA W. J. Robb III (&) Department of Orthopaedic Surgery, NorthShore University HealthSystem, Walgreen Building, 2650 Ridge Avenue, Suite 2505, Evanston, IL 60201, USA e-mail: [email protected] W. J. Robb III Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
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Methods We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE1 database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Results Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Conclusions Successful surgical safety progr
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