Optimizing the Safety of Surgery, Before Surgery

Excerpt

As the healthcare environment continues to progress to a pay-for-performance model, physicians and medical centers are under increasing pressure to demonstrate the safety of care through a myriad of mechanisms including checklists, surgical timeouts, and quality metrics. Safety is measured not only by the occurrence and rate of the egregious never events (wrong site surgery, retained foreign body), but also by the occurrence and rate of known adverse events (deep venous thrombosis, infection, and readmission). The vast majority of the attention in improving safety in surgery has appropriately focused on how surgery is done, and how patients are managed afterwards. But we tend to ignore what is done for the patient before surgery. How can we optimize patients before surgery, so as to minimize the risk of a complication afterwards? …