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Keeping Surgeries Safe!


Surgeons are among the most revered and trusted medical professionals. With a surgical blade in hand, they have the power to cure their patient of several acute or chronic ailments. In return, the patient and their families extend their unlimited trust and gratitude. Even though all doctors take the Hippocratic oath of doing no harm, unfortunately sometimes the patients are at the receiving ends when a surgery results in a severe complication. It is even more unfortunate when this happens due to an avoidable negligence.

Conventional wisdom suggests that the culprit could be a surgical blade gone awry. However, in several studies conducted by WHO and other associations, it has been found that more often than not, the cause of such errors lies in one of the three below.

  1. Breakdown of communication between the surgical team, care team, patients and their family
  2. Delay in diagnosis or failure to diagnose
  3. Delay in treatment or failure to treat

We do not have a system in India at present to keep track of how many surgeries are conducted each year, much less record the outcome of such procedures. However, even in the most developed healthcare system such as that of United States, it has been registered that as many as 1,80,000 people insured under the government insurance plan called Medicare died due to hospital mistakes in Year 2010. With the reports cited in Journal of Patient Safety, it was estimated that total annual deaths due to negligent medical care could be as high as 4,40,000!

Analysis of adverse medical events suggests that the most common source are often preventable errors during surgeries. As many as 43% of incidents were categorised as avoidable mistakes. Globally an estimated 234 million operations are performed annually. (Source: WHO Report). As many as 7 million surgeries may result in some complications of which 1 million cases are estimated to result in death! (Source: Oxford Journal)

That is why WHO has come up with a Surgery Safety guideline that suggests very simple steps to avoid such errors. Here is the link to the detailed safety checklist.

http://www.who.int/patientsafety/safesurgery/tools_resources/SSSL_Checklist_finalJun08.pdf

The issues pertaining to delay in diagnosis can be easily addressed by taking few more medical opinions. It is important that a second opinion is taken not only when a surgery has been advised, but also when it has not been suggested, and the nature of the disease is a chronic and serious one. Research has shown that a delayed surgery can also lead to worse outcomes.

While it is up to the hospitals to adopt the checklists, before you are knocked down unconscious, this is the minimum you can do from your end.

  • Get your identity confirmed by the surgery team.
  • Confirm the site where surgery is to be carried out.
  • Confirm the surgery procedure.
  • Enquire for possible complications during surgery such as breathing or blood loss.

After this, it is after that for the hospital and surgical team to follow the down-stream checklists but as an informed patient, you have every right to bring that to the attention of your doctor. While your consent to go under the knife demonstrates your utmost trust in your doctor, at the same time, it is important that you feel empowered enough to express your concerns and needs to your surgeon.

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