Handbook of Perioperative and Procedural Patient Safety

1st Edition - March 10, 2023
Editors: Juan A Sanchez, Robert S. D. Higgins, Paula S. Kent
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 6 6 1 7 9 - 9
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 7 4 8 4 - 3

Offering a concise yet comprehensive review of current practices in surgery and patient safety, Handbook of Perioperative and Procedural Patient Safety is an up-to date, practical… Read more

Handbook of Perioperative and Procedural Patient Safety

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Offering a concise yet comprehensive review of current practices in surgery and patient safety, Handbook of Perioperative and Procedural Patient Safety is an up-to date, practical resource for practicing surgeons, anesthesiologists, surgical nurses, hospital administrators, and surgical office staff. Edited by Drs. Juan A. Sanchez and Robert S. D. Higgins and authored by expert contributors from Johns Hopkins, it provides an expansive look at the scope of the problem, causes of error, minimizing errors, surgical suite and surgical team design, patient experience, and other related topics.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Preface
Chapter 1. The science of human error
What is human error?
Human error and healthcare
Person approach versus the system approach 9
Swiss cheese model
Case study
Active failures and latent conditions
Summary
Chapter 2. The scope and prevalence of perioperative harm
The scope of perioperative care
The prevalence of perioperative harm
Patient safety initiatives to reduce perioperative harm
Recommendations to advance perioperative practice
Chapter 3. Systems thinking in the operating room
Introduction
Systems approach
Conclusion
Chapter 4. Culture of safety
Background
Definitions
Tenets of safety culture
Chapter 5. Dynamics of surgical teams
Team components and responsibilities
Traditional approach
Careful planning
Communication
Coordination
Collaboration
Training
Critical care handoff
Summary
Chapter 6. Structured perioperative team communication
The need for structured and effective perioperative team communication
The Joint Commission's surgical time-out
The World Health Organization's surgical checklists
Preoperative briefings
Postoperative debriefings
Handoffs to next level of care
Tools to implement structured and effective communication
Future directions
Chapter 7. Human factors and ergonomics in the operating room
Defining human factors and ergonomics
Human factors and ergonomics in healthcare
The effects of poor physical ergonomics
Physical ergonomic considerations and recommendations
Chapter 8. Prehabilitation and enhanced recovery after surgery
Introduction
Prehabilitation: preoperative ERAS elements
Intraoperative ERAS elements
Postoperative ERAS elements
Benefits of ERAS protocols
Implementation of an ERAS protocol
Conclusion
Chapter 9. Preoperative preparation of the surgical patient
Comorbidities
Medication management
Conclusion
Chapter 10. Designing safe procedural sedation: adopting a resilient culture
Introduction
Preprocedural assessment
Preprocedural airway assessment
Levels of sedation
Patient selection and screening
Medications used for sedation (Table 10.11)
Monitoring
Human error, performance limitations, and complications
Postprocedural care
Applying human factors in the clinical environment
Chapter 11. Enhancing medication safety during the perioperative period
Introduction
Medication safety hazards and risk management during the perioperative period (Fig. 11.1)
Conclusions, unmet needs, and future research directions
Chapter 12. Surgical site and other acquired perioperative infections
Introduction
Definition of healthcare-associated infections
Surgical site infections
Other healthcare-associated infections
Reducing infectious complications requires an interprofessional approach
Conclusion
Chapter 13. Occupational well-being, resilience, burnout, and job satisfaction of surgical teams
Perioperative teams
Work climate
The power of motivation
The importance of job satisfaction in perioperative team members
Role of personality
Burnout and physical health
Fatigue and medical errors
Sustainable employability and its impact on occupational wellness and joy at work
Chapter 14. Redesigning the operating room for safety
Why design matters?
Is there an optimal OR design?
Components of an OR
Future directions
Chapter 15. A perioperative safety and quality change management model and case study: Muda Health
Introduction
Case study
What was done?
High reliability organization (HRO) framework for surgery quality improvement (Fig. 15.3)
How was the quality improvement activity implemented?
Description of the quality improvement activity
Quality guiding principles adopted by Muda Health leadership and staff
New governance structure and timeline for perioperative services transformation (Appendix I, II, III, IV, V)
Designing the new workflow
Admissions into surgical services
Internal transitions
Patient family/friends care
Scheduling of staff and surgical suites
Supplies
Sterilization
Surgical preparation
Physician preparation
Keeping score—construction of the data scorecards and leadership dashboards
Key components of a balanced scorecard approach
Training of the MH staff, clinicians and leadership (Appendix IX)
Communications and messaging—internal and external
Cost savings
Tips for others planning surgical quality improvement initiatives
Conclusions—path toward high reliability and safe surgical care
List of appendices
Appendix I. Team roles
Appendix II. Before–during–after (BDA) surgery project charters
Appendix III. Meeting location and team etiquette
Appendix IV. Identify the process(es) and scope
Appendix V. Proposed timeline for a perioperative improvement project
Appendix VI. BDA reports to the leadership steering team
Appendix VII. Recommendations for the before surgery, during surgery, after surgery teams
Appendix VIII. Analyzing add-on surgical cases deep dive (pg. 309–323)
Appendix IX. Kaizen training to ready the MH staff and clinicians for the project
Index

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Handbook of Perioperative and Procedural Patient Safety

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Juan A Sanchez

Robert S. D. Higgins

Paula S. Kent