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Organisational failures in urgent and emergency surgeryA potential peri‐operative risk factor
Author(s) -
Pearse R. M.,
Dana E. C.,
Lanigan C. J.,
Pook J. A. R.
Publication year - 2001
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2001.01374-4.x
Subject(s) - medicine , incidence (geometry) , risk factor , medical emergency , emergency surgery , patient safety , emergency medicine , intensive care medicine , surgery , health care , physics , optics , economics , economic growth
Medical error is an important cause of morbidity and mortality. Organisational failure in the pre‐operative period has been associated with catastrophic outcome. Little information is available regarding peri‐operative organisational problems. The incidence and nature of organisational failure before urgent and emergency surgery in a district general hospital was studied prospectively in 159 cases over a 30‐day period. Organisational failure affected more than half of the cases overall, but varied in both its incidence and its complexity between surgical disciplines. Various causative factors were identified, e.g. 8% of cases were subject to delay due to clinical emergencies. The median [range] time required to rectify the problems was 115 [5−750] min. A consultant anaesthetist and surgeon were present in 30 and 20% of cases, respectively. Difficulty with the preparation of patients for emergency surgery is an important but underevaluated cause of medical error that may put patients at risk.