ACS Surgery: Principles & Practice 2005 edition - download pdf or read online

By Wiley W. Souba; Mitchell P. Fink; Gregory J. Jurkovich; Larry R. Kaiser; William H. Pearce; John H. Pemberton; Nathaniel J. Soper

ISBN-10: 097483274X

ISBN-13: 9780974832746

Annual entire source for surgeons presents the data wanted for continuous ability refinement and to accomplish key methods extra successfully. up-to-date variation contains an elevated reduce gastrointestinal (GI) part. textual content with CD-ROM additionally to be had. DNLM: surgeries, Operative--methods.

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34 Some authorities classify error according to whether it can be addressed by engineering, design, societal, or procedural changes; others emphasize psychological intervention and modification; and still others classify errors by their mode of appearance. , misadministration of lidocaine, heparin, or potassium chloride as a result of poor package labeling). 59 These arguments notwithstanding, elimination of human errors is clearly an impossible goal: a more realistic goal is to understand what causes errors and to minimize or, if possible, eliminate their consequences.

The present professional liability system is particularly controversial. 54 In addition, the liability system compensates fewer than one in eight patients who are harmed; awards such compensation only after years of litigation; is based on determination of fault where experts cannot agree (often as a result of hindsight bias); and causes devastating emotional damage to physicians (and their families),12,55,56 which may adversely affect their problem-solving abilities. To the extent that experience with or fear of a malpractice action deters efforts at quality improvement, it is counterproductive.

For example, appropriate use of perioperative antibiotics in surgical patients is a good quality-improvement measure: it is clinically meaningful, linked to lower SSI rates, and directly actionable. This process of care would not, however, be particularly useful for selective referral purposes. In the first place, patients are unlikely to base their decision about where to undergo surgery on patterns of perioperative antibiotic use. , mortality). 23 As a counterexample, the two main performance measures for pancreatic cancer surgery—hospital volume and operative mortality—are very informative in the context of selective referral: patients can markedly improve their chances of surviving surgery by selecting hospitals highly ranked on either measure [see Figure 1].

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ACS Surgery: Principles & Practice 2005 edition by Wiley W. Souba; Mitchell P. Fink; Gregory J. Jurkovich; Larry R. Kaiser; William H. Pearce; John H. Pemberton; Nathaniel J. Soper


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