Surgery targets endanger patient safety

The BBC reports that

About one in five of the nearly 600 surgeons questioned by Bournemouth University reported being involved in incidents, during a two-week period, where patients were harmed.

Using the figures further on in the article of 549 surgeons questioned and 19% seeing harm, that means that in two weeks, 104 surgeons saw a patient harmed. I wouldn’t even like to start extrapolating that figure to all the surgeons and all year long.

Apart from the fact that

When asked about what gets in the way of patient safety, many said they did not feel in full clinical control, because of pressure from managers to get through operating lists.

The report author said that

surgeons often come under pressure to “slip in” extra patients on their lists

These are systemic problems. The management are putting pressure on the individual surgeons to make up for the lack of systemic thinking about how patients are treated. “Slipping in” patients to surgery lists means that not only are the lists tampered with but so is the whole patient flow. There is probably a lack of understanding of demand and little or no flow of patients or continuity of care which is leading to these comments.

Many [surgeons] complained of having to operate on patients they had not seen before

If patients came to see a surgeon and their surgery was scheduled quickly, then this would occur much less frequently.

The bottom line is that surgeons, managers and all staff involved in the care of patients having operations need to be aware of and contribute to the end-to-end system that patients experience. No one section of the flow should start blaming the others, they all have a responsibility to get together to improve. The problem is that there are currently no structures in the NHS that assist them to do that. Combining GPs, PCTs, SHAs, hospital trusts and the other agencies that affect these flows is a mammoth task that is not being addressed yet.

We shall continue to see these kind of articles until something brings these systems all together.

Best,

Rob

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