Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery

Abstract

Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries.

Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

“…'Failure to rescue' and similar metrics have been successfully used to support data driven quality improvement projects. 33 Our findings suggest that the drivers of perioperative death may be broadly consistent across Africa, although further prospective audit is required to understand the site-specific drivers in individual hospitals, and countries. Recent work has demonstrated the feasibility of surgical outcomes audit in low-income countries.…”

Canadian Anesthesia Incident Reporting System (CAIRS): The Canadian Anesthesiologists’ Society’s National Patient Safety Initiative

“…Les données les plus récentes provenant de l'essai ISOS (International Surgical Outcomes Trial) montrent que plus de 10 % des patients présentent un événement indésirable postopératoire modéré à sévère. 2,3 Cet échec, qu'il soit en rapport avec la chirurgie ou l'anesthésie, entraîne un allongement des hospitalisations et de leur coût, [4][5][6] ainsi qu'une augmentation du nombre de plaintes pour négligence. 7 On ignore dans quelle mesure ces événements indésirables sont secondaires à des erreurs et/ ou à des ratés des processus de soins (les rendant donc évitables).…”

“…The most recent data from the International Surgical Outcomes Trial (ISOS) show that more than 10% of patients suffer a moderate-to-severe adverse postoperative event. 2,3 This adversity, be it surgical or anesthesia related, results in increased hospital stay and cost [4][5][6] as well as increasing negligence claims. 7 The extent to which these adverse events are secondary to errors and/or a breakdown in processes of care, and therefore preventable, is unknown.…”

Out of Africa: three generalisable lessons about clinical research

“…The ASOS investigators also made the most of their valuable resource by conducting additional studies, including this survey. 2,10 Many investigators undertake sub-studies (which answer additional questions using additional data collected in a subset of participants 11 ), sub-analyses (which answer additional questions using the data collected for the main study 12 ), and systematic reviews (which pool the investigators' results with previous research 13 ), and write opinion pieces to explain and contextualise their findings. 14 Apart from generating new information, these studies provide opportunities to involve and recognise site investigators and to develop emerging research leaders.…”