Detecting adverse events in dermatologic surgery.
BACKGROUND
Despite increasing awareness of and public attention to patient safety, little is documented about how adverse events (AEs) can or should be monitored in dermatologic surgery. Data to address this shortcoming are needed, although well-defined methodologies have yet to be implemented. OBJECTIVE To summarize current strategies in detecting adverse outcomes of dermatologic surgical procedures.


METHODS
A Medline literature search was conducted using the terms "adverse event,""detection,""reporting,""monitoring," and "surgery." Articles selected addressed the efficacy of one or more AE reporting techniques in surgical patients.


RESULTS
Prospective and retrospective reporting methods were identified, with morbidity and mortality conference being the most commonly used method of AE reporting. Retrospective medical record review, the retrospective trigger tool approach, and an anonymous electronic reporting system were more sensitive approaches. The Surgical Quality Improvement Program, a program that has successfully translated AE data into lower postoperative morbidity and mortality, was analyzed.


CONCLUSIONS
Although generally considered safe, dermatologic surgery has no current standard for AE reporting. Standard definitions and high-quality data regarding AEs" currently limit this analysis. Pilot studies are needed to develop feasible measures, with the goal of increasing the sensitivity of AE detection and ultimately improving patient outcomes.
Pinney
Daniel
D
Department of Dermatology, Center for Dermatology Research, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA. sfeldman@wfubmc.edu
Pearce
Daniel J
DJ
Feldman
Steven R
SR
D062109:Dermatologic Surgical Procedures; D003880:Dermatology / Q000592:standards*; D006801:Humans; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care; D012107:Research Design; D017751:Safety Management; D013514:Surgical Procedures, Operative / Q000009:adverse effects*