title: Surgical innovation-enhanced quality and the processes that assure patient/provider safety: A surgical conundrum.
abstract: Innovation is a crucial part of surgical history that has led to enhancements in the quality of surgical care. This comprises both changes which are incremental and those which are frankly disruptive in nature. There are situations where innovation is absolutely required in order to achieve quality improvement or process improvement. Alternatively, there are innovations that do not necessarily arise from some need, but simply are a new idea that might be better. All change must assure a significant commitment to patient safety and beneficence. Innovation would ideally enhance patient care quality and disease outcomes, as well stimulate and facilitate further innovation. The tensions between innovative advancement and patient safety, risk and reward, and demonstrated effectiveness versus speculative added value have created a contemporary "surgical conundrum" that must be resolved by a delicate balance assuring optimal patient/provider outcomes. This article will explore this delicate balance and the rules that govern it. Recommendations are made to facilitate surgical innovation through clinical research. In addition, we propose options that investigators and institutions may use to address competing priorities.
authors.affiliation: Department of Surgery, Children׳s Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave, Aurora, Colorado 80045. Electronic address: Jennifer.bruny@childrenscolorado.org.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bruny
authors.affiliation: Department of Surgery, Children׳s Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave, Aurora, Colorado 80045.
authors.forename: Moritz
authors.initials: M
authors.lastname: Ziegler
mesh_terms: D006805:Human Experimentation / Q000941:ethics / Q000592:standards; D006801:Humans; D009936:Organizational Innovation; D061214:Patient Safety / Q000592:standards*; D010372:Pediatrics / Q000941:ethics / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000941:ethics / Q000458:organization & administration*; D058996:Quality Improvement / Q000941:ethics / Q000458:organization & administration*; D013043:Specialties, Surgical / Q000941:ethics / Q000592:standards*; D014481:United States
keywords: Ethics; Innovation; Quality improvement