Surgeons and systems working together to drive safety and quality

Hawkins, Robert B.; Nallamothu, Brahmajee K.

doi:10.1136/bmjqs-2022-015045

Cited by 2 publications

(4 citation statements)

References 20 publications

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“…This take validates a recent review reporting on the promotion of formal and informal communication and teamwork and how it allows health professionals to consolidate their knowledge, fostering ‘leading initiatives to improve patient safety’ 99. The urgency of taking actions to ensure establishment of synergies between health professionals’ safety and patient safety is recognised as a key future policy topic and paying attention to the connections between individual surgeon and system factors 100 101. Illustrated by this study’s results, a less fragmented application of for instance M&M conferences, a systemic case-based approach, with boundaries against attention to specific individual performance factors and where aspects of successful activities, techniques and outcomes become part of the discussions, may serve as a means of aligning system-level and individual-level learning.…”

Section: Discussionsupporting

confidence: 70%

Learning from experience: a qualitative study of surgeons’ perspectives on reporting and dealing with serious adverse events

Øyri

Søreide

et al. 2023

BMJ Open Qual

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IntroductionIn surgery, serious adverse events have effects on the patient journey, the patient outcome and may constitute a burden to the surgeon involved. This study aims to investigate facilitators and barriers to transparency around, reporting of and learning from serious adverse events among surgeons.MethodsBased on a qualitative study design, we recruited 15 surgeons (4 females and 11 males) with 4 different surgical subspecialties from four Norwegian university hospitals. The participants underwent individual semistructured interviews and data were analysed according to principles of inductive qualitative content analysis.Results and discussionWe identified four overarching themes. All surgeons reported having experienced serious adverse events, describing these as part of ‘the nature of surgery’. Most surgeons reported that established strategies failed to combine facilitation of learning with taking care of the involved surgeons. Transparency about serious adverse events was by some felt as an extra burden, fearing that openness on technical-related errors could affect their future career negatively. Positive implications of transparency were linked with factors such as minimising the surgeon’s feeling of personal burden with positive impact on individual and collective learning. A lack of facilitation of individual and structural transparency factors could entail ‘collateral damage’. Our participants suggested that both the younger generation of surgeons in general, and the increasing number of women in surgical professions, might contribute to ‘maturing’ the culture of transparency.Conclusion and implicationsThis study suggests that transparency associated with serious adverse events is hampered by concerns at both personal and professional levels among surgeons. These results emphasise the importance of improved systemic learning and the need for structural changes; it is crucial to increase the focus on education and training curriculums and offer advice on coping strategies and establish arenas for safe discussions after serious adverse events.

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Section: Discussionsupporting

confidence: 70%

Learning from experience: a qualitative study of surgeons’ perspectives on reporting and dealing with serious adverse events

Øyri

Søreide

et al. 2023

BMJ Open Qual

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“…I snitt jobber leger mer enn vanlige arbeidstakere i Norge, og overtid er en «patologisk» del av både arbeidsgivers forventninger og lønnen (3). Stor arbeidsbyrde, begrenset mestring i jobben, høyt tempo og ineffektive systemer kan gi negativ effekt på behandlingskvalitet (2,6). At etterspørselen etter spesialister overstiger tilgangen, forsterker utfordringsbildet (3).…”

Section: «åPenhet Kan Bidra Til Individuell Og Kollektiv Laering Svek...unclassified

“…Dette ansvarsskillet gjelder også hendelser som er uønskede, der pasientbehandlingen har sviktet og pasienten har blitt skadet (4,5). Flere undersøkelser har vist at et individrettet fokus i forbindelse med uønskede hendelser i helsetjenesten kan vaere personlig og profesjonelt uheldig (1,(4)(5)(6)(7). Funn tyder på at et sanksjonsfritt miljø er det som best kan fremme kultur for deling, laering og forbedring (4,5,8).…”

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“…Funn tyder på at et sanksjonsfritt miljø er det som best kan fremme kultur for deling, laering og forbedring (4,5,8). Norsk pasientskadeerstatning har sitt utspring i ideen om at det offentlige skal pulverisere ansvaret på vegne av Legers arbeidsmiljø og helse -et samfunnsansvar | Tidsskrift for Den norske legeforening SINA FURNES ØYRI helsepersonellet, fordi det ytterst sjelden dreier seg om bevisste skadehandlinger (1,(4)(5)(6)(7). På generelt grunnlag bør derfor ikke pasientskader føre til personlig straffe-eller erstatningsansvar for helsepersonell.…”

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Legers arbeidsmiljø og helse – et samfunnsansvar

Øyri

2023

Tidsskriftet

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Surgeons and systems working together to drive safety and quality

Cited by 2 publications

References 20 publications

Learning from experience: a qualitative study of surgeons’ perspectives on reporting and dealing with serious adverse events

Learning from experience: a qualitative study of surgeons’ perspectives on reporting and dealing with serious adverse events

Legers arbeidsmiljø og helse – et samfunnsansvar

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