Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approach
OBJECTIVE: We sought to evaluate potential reasons given by board-certified doctors for the persistence of adverse events despite efforts to improve patient safety in Switzerland. SUMMARY BACKGROUND DATA: In recent years, substantial efforts have been made to improve patient safety b...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2013-09-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1759 |
| _version_ | 1798003653136613376 |
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| author | Reto Kaderli Julia C. Seelandt Melika Umer Franziska Tschan Adrian P. Businger |
| author_facet | Reto Kaderli Julia C. Seelandt Melika Umer Franziska Tschan Adrian P. Businger |
| author_sort | Reto Kaderli |
| collection | DOAJ |
| description |
OBJECTIVE: We sought to evaluate potential reasons given by board-certified doctors for the persistence of adverse events despite efforts to improve patient safety in Switzerland.
SUMMARY BACKGROUND DATA: In recent years, substantial efforts have been made to improve patient safety by introducing surgical safety checklists to standardise surgeries and team procedures. Still, a high number of adverse events remain.
METHODS: Clinic directors in operative medicine in Switzerland were asked to answer two questions concerning the reasons for persistence of adverse events, and the advantages and disadvantages of introducing and implementing surgical safety checklists. Of 799 clinic directors, the arguments of 237 (29.7%) were content-analysed using Mayring’s content analysis method, resulting in 12 different categories.
RESULTS: Potential reasons for the persistence of adverse events were mainly seen as being related to the “individual” (126/237, 53.2%), but directors of high-volume clinics identified factors related to the “group and interactions” significantly more often as a reason (60.2% vs 40.2%; p = 0.003). Surgical safety checklists were thought to have positive effects on the “organisational level” (47/237, 19.8%), the “team level” (37/237, 15.6%) and the “patient level” (40/237, 16.9%), with a “lack of willingness to implement checklists” as the main disadvantage (34/237, 14.3%).
CONCLUSION: This qualitative study revealed the individual as the main player in the persistence of adverse events. Working conditions should be optimised to minimise interface problems in the case of cross-covering of patients, to assure support for students, residents and interns, and to reduce strain. Checklists are helpful on an “organisational level” (e.g., financial benefits, quality assurance) and to clarify responsibilities.
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| first_indexed | 2024-04-11T12:11:11Z |
| format | Article |
| id | doaj.art-f099a89cb4614d88a8c3f4f524f64f2b |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T12:11:11Z |
| publishDate | 2013-09-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-f099a89cb4614d88a8c3f4f524f64f2b2022-12-22T04:24:36ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972013-09-01143394010.4414/smw.2013.13882Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approachReto KaderliJulia C. SeelandtMelika UmerFranziska TschanAdrian P. Businger OBJECTIVE: We sought to evaluate potential reasons given by board-certified doctors for the persistence of adverse events despite efforts to improve patient safety in Switzerland. SUMMARY BACKGROUND DATA: In recent years, substantial efforts have been made to improve patient safety by introducing surgical safety checklists to standardise surgeries and team procedures. Still, a high number of adverse events remain. METHODS: Clinic directors in operative medicine in Switzerland were asked to answer two questions concerning the reasons for persistence of adverse events, and the advantages and disadvantages of introducing and implementing surgical safety checklists. Of 799 clinic directors, the arguments of 237 (29.7%) were content-analysed using Mayring’s content analysis method, resulting in 12 different categories. RESULTS: Potential reasons for the persistence of adverse events were mainly seen as being related to the “individual” (126/237, 53.2%), but directors of high-volume clinics identified factors related to the “group and interactions” significantly more often as a reason (60.2% vs 40.2%; p = 0.003). Surgical safety checklists were thought to have positive effects on the “organisational level” (47/237, 19.8%), the “team level” (37/237, 15.6%) and the “patient level” (40/237, 16.9%), with a “lack of willingness to implement checklists” as the main disadvantage (34/237, 14.3%). CONCLUSION: This qualitative study revealed the individual as the main player in the persistence of adverse events. Working conditions should be optimised to minimise interface problems in the case of cross-covering of patients, to assure support for students, residents and interns, and to reduce strain. Checklists are helpful on an “organisational level” (e.g., financial benefits, quality assurance) and to clarify responsibilities. https://www.smw.ch/index.php/smw/article/view/1759adverse eventindividualorganizational levelpatient safetyqualitative analysissurgical checklist |
| spellingShingle | Reto Kaderli Julia C. Seelandt Melika Umer Franziska Tschan Adrian P. Businger Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approach Swiss Medical Weekly adverse event individual organizational level patient safety qualitative analysis surgical checklist |
| title | Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approach |
| title_full | Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approach |
| title_fullStr | Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approach |
| title_full_unstemmed | Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approach |
| title_short | Reasons for the persistence of adverse events in the era of safer surgery – a qualitative approach |
| title_sort | reasons for the persistence of adverse events in the era of safer surgery a qualitative approach |
| topic | adverse event individual organizational level patient safety qualitative analysis surgical checklist |
| url | https://www.smw.ch/index.php/smw/article/view/1759 |
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