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1. Patient harm due to medical mistakes can be catastrophic and, in some cases, result in high-profile consequences not only for the patient, but also for the surgeon and institution.

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2. Patient safety is a science that promotes the use of evidence-based medicine and commonsense improvements in an attempt to minimize the impact of human error on the routine delivery of services.

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3. The structure-process-outcome framework within the context of an organization’s culture helps to clarify how risks and hazards embedded within the organization’s structure may potentially lead to error and injure or harm patients.

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4. Poor communication contributes to approximately 70% of the sentinel events reported to the Joint Commission on Accreditation of Healthcare Organizations.

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5. Operating room briefings are team discussions of critical issues and potential hazards that can improve the safety of the operation and have been shown to improve operating room culture and decrease operating room delays.

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6. National Quality Forum surgical “never events” include retained surgical items, wrong-site surgery, and death on the day of surgery of a normal healthy patient (ASA Class 1).

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7. Patient rapport is the most important determinant of malpractice claims against a surgeon.

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Patient harm due to medical mistakes can be catastrophic and, in some cases, result in high-profile consequences not only for the patient, but also for the surgeon and institution. A single error can even destroy a surgeon’s career. Yet, medical mistakes are common to every physician, and errors themselves are unavoidably linked to human nature. Only recently has the science of the delivery of health care matured to recognize the contribution of vulnerable hospital systems in addition to individual responsibility in causing error.

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Patient safety is a science that promotes the use of evidence-based medicine and commonsense improvements in an attempt to minimize the impact of human error on the routine delivery of services. Wrong-site/wrong-procedure surgeries, retained sponges, unchecked blood transfusions, mismatched organ transplants, and overlooked allergies are all examples of potentially catastrophic events that can be prevented by implementing safer hospital systems. This chapter provides an overview of the modern day field of patient safety by reviewing key measures of safety and quality, components of culture, interventions and tools, and risk management strategies in surgery.

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Medicine is considered a high-risk system with a high error rate, but these two characteristics are not always correlated. Other high-risk industries have managed to maintain an impeccably low error rate. For example, one of the highest risk systems in existence today, the U.S. Navy’s nuclear submarine program, has an unmatched safety record. The nuclear fleet has achieved this safety record despite the large number of plants in operation, the added complexity of the reactors being mobile instead of fixed in one location, the secrecy of its operations, and the hazards of engaging in demanding exercises with both friendly and hostile ...

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