Dedicated teams to optimize quality and safety of surgery: A systematic review

Lentz, C M; Wijngaarden, Rob A F de Lind van; Willeboordse, F; Hooft, L; Laan, Maarten J. van der

doi:10.1093/intqhc/mzac078

Cited by 9 publications

(2 citation statements)

References 26 publications

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“…Operating at these times can be disruptive to a surgeon’s schedule. Surgery is more difficult and less efficient outside of normal operational hours due to the absence of ancillary staff who are familiar with PP procedures ( 25 ). However, patients are commonly hemodynamically stable on presentation with PP infection.…”

Section: Resultsmentioning

confidence: 99%

Overcoming barriers to immediate penile implant salvage surgery: a narrative review

Grimaud,

Barquin,

Kurnot

et al. 2024

Transl Androl Urol

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Background and Objective Since immediate salvage (IS) surgery for infected penile prosthesis (PP) was introduced nearly 30 years ago, an abundance of evidence has emerged in support of its use. IS remains underutilized by the modern urologist despite its distinct advantages. While some medical literature proposes reasons for the underuse of IS, no comprehensive review attempts to address the numerous factors limiting its implementation. Our objective is to analyze the barriers to IS surgery for infected PP with the goal of expanding utilization of this technique through a practical and standardized approach for treating urologists. Methods A narrative review of available English, peer-reviewed, medical literature relevant to the barriers to IS was completed. Searches were expanded to include literature from surgical specialties in general if hypothesized barriers were incompletely described in available PP publications. Key Content and Findings The major barriers that are likely contributing to the low rates of IS for PP surgery can be broadly classified into three major categories: institutional/systemic, medical/surgical, and patient preference. Institutional/systemically driven barriers include surgeon comfort with PP surgery, low national availability of urologists, inaccessibility of prosthetics or critical ancillary staff at the time of patient presentation and limited operating room (OR) access. Medical/surgical barriers primarily relate to reinfection fears, perceived contraindications to IS, and overall patient stability at the time of presentation. Patient preference factors inhibiting IS involve loss of trust in the medical team, psychosocial distress, dissatisfaction with the initial device prior to infection and anxiety regarding postoperative recovery. Many of the identified barriers can be overcome with increased surgical training, improved patient and surgeon understanding of PP infection, or precautionary planning. Conclusions Of the factors that contribute to low utilization of IS, many are misunderstood or unknown. Recognition of these barriers may equip urologists to provide better care to patients with prosthesis infection.

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Section: Resultsmentioning

confidence: 99%

Overcoming barriers to immediate penile implant salvage surgery: a narrative review

Grimaud,

Barquin,

Kurnot

et al. 2024

Transl Androl Urol

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“…Team performance was a key contributory factor and an area addressed within our key enablers. Improving team dynamics and performance is a key factor in improving safety across much of the wider literature [32]. Specifically, development of non-technical skills training may improve team performance and ultimately patient safety [33].…”

Section: Team Performancementioning

confidence: 99%

Patient safety incidents in endoscopy: a human factors analysis of nonprocedural significant harm incidents from the National Reporting and Learning System (NRLS)

Ravindran,

Matharoo,

Rutter

et al. 2023

Endoscopy

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BACKGROUND AND AIMS Despite advances in understanding and reducing risk of endoscopic procedures, there is little consideration of the safety of the wider endoscopy service. Patient safety incidents (PSIs) still occur. We sought to identify non-procedural PSIs (nPSIs) and their causative factors from a human factors perspective and generate ideas for safety improvement. METHODS Endoscopy-specific PSI reports were extracted from the National Reporting and Learning System (NRLS). A retrospective, cross-sectional human factors analysis of data was performed. Two independent researchers coded data using a hybrid thematic analysis approach. The Human Factors Analysis and Classification System (HFACS) was used to code contributory factors. Analysis informed creation of driver diagrams and key recommendations for safety improvement in endoscopy. RESULTS From 2017 – 2019, 1181 endoscopy-specific PSIs of significant harm were reported across England and Wales. Of these, 539 (45.6%) were nPSIs. Five categories accounted for over 80% of all incidents with ‘follow up and surveillance’ being the largest (23.4% of all nPSIs). 487 human factors codes were identified from free-text incident reports. Decision-based errors were the most common act prior to PSI occurrence. Preconditions to incident focussed on environmental factors, particularly overwhelmed resources, patient factors, and ineffective team communication. Lack of staffing, standard operating procedures, effective systems, and clinical pathways were also contributory. Seven key recommendations for improving safety are made in response to our findings. CONCLUSIONS This was the first national-level human factors analysis of endoscopy-specific PSIs. This work will inform safety improvement strategies and should empower individual services to review their approach to safety.

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Evaluating and Assessing Your Team

DuCoin

2024

The SAGES Manual of Strategy and Leadership

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Dedicated teams to optimize quality and safety of surgery: A systematic review

Cited by 9 publications

References 26 publications

Overcoming barriers to immediate penile implant salvage surgery: a narrative review

Overcoming barriers to immediate penile implant salvage surgery: a narrative review

Patient safety incidents in endoscopy: a human factors analysis of nonprocedural significant harm incidents from the National Reporting and Learning System (NRLS)

Evaluating and Assessing Your Team

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