title: [A safer surgical pathway: monitoring in the operation room alone is insufficient].
abstract: Surgical adverse events remain a considerable problem: over 50% of in-hospital adverse events are related to a surgical procedure. The WHO, in its 'Safe surgery saves lives' campaign, propose what is essentially an expanded time-out procedure, including a debriefing. In recent years, this type of procedure has been widely advocated and implemented. While it is valuable, it has one major drawback: it is limited to the operating room. We recently observed 170 patients undergoing surgery. Over 50% of the incidents observed occurred outside the operating room, before and/or after surgery. Many near misses can be intercepted before entering the operating room. We therefore developed and validated a multidisciplinary checklist that covers the entire surgical patient pathway, instead of just the operative phase. The implementation of the so-called 'Surgical patient safety system' (SURPASS) checklist is currently underway. The effectiveness of the checklist in reducing adverse events and improving patient safety is being studied.
authors.affiliation: Afd. Chirurgie, Academisch Medisch Centrum/Universiteit van Amsterdam, Amsterdam.
authors.forename: E N
authors.initials: EN
authors.lastname: de Vries
authors.forename: S M
authors.initials: SM
authors.lastname: Smorenburg
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: M A
authors.initials: MA
authors.lastname: Boermeester
mesh_terms: D006801:Humans; D009873:Operating Rooms / Q000592:standards* / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control*; D017751:Safety Management; D013514:Surgical Procedures, Operative / Q000009:adverse effects*