Liver transplant quality and safety plan in anesthesia and intensive care medicine.
Patients scheduled for orthotopic liver transplantation (OLT) may have coexisting diseases and more likely receive grafts of poorer quality than in the past. Perioperative mortality and morbidity are usually due to a combination of factors related to the patient, graft, surgery, anesthesia, and intensive care management. Anesthesia and intensive care are the areas with the highest frequency and severity of errors. Error and accident risks are always present in this context where a human component is unavoidable. The matter of medical errors is becoming noteworthy worldwide. Nevertheless, data concerning medical errors during OLT are not available in Italy. There are only hypothetical evaluations. The number of adverse events may be high, but so far no specific programs have been developed to increase patient safety. To improve patient safety, anesthesia and intensive care units must use a proactive approach dedicated to an OLT program. We have presented herein a prevention policy to detect errors before they happen through incident reporting, anonymous and voluntary reports of adverse events or near misses, operating room checklists (patient, drugs, devices, equipment), improved training, safer facilities, equipment function, and adequate drug supplies for an OLT program.
Della Rocca
G
G
Clinic of Anesthesia and Intensive Care Medicine, Department of Surgical Science, Medical School, University of Udine, Udine, Italy.
De Flaviis
A
A
Costa
M G
MG
Chiarandini
P
P
Pompei
L
L
Venettoni
S
S
D000758:Anesthesia / Q000009:adverse effects / Q000592:standards*; D000776:Anesthesiology / Q000592:standards; D001803:Blood Transfusion / Q000592:standards; D003422:Critical Care / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D016031:Liver Transplantation / Q000401:mortality / Q000473:pathology / Q000592:standards*; D009873:Operating Rooms / Q000592:standards; D019990:Perioperative Care / Q000401:mortality; D010950:Plasma Cells / Q000637:transplantation; D017713:Platelet Transfusion / Q000592:standards; D011182:Postoperative Care / Q000009:adverse effects / Q000592:standards; D011183:Postoperative Complications / Q000145:classification; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D012449:Safety