How to Avoid Malpractice

Another suggestion is to have the surgeon confirm, as part of the surgical briefing or time out before every surgery, that “all team members have introduced themselves by name and role,” noted Dr. Nussenbaum. “That sets the culture in the room.” Research has shown that by giving people a chance to say something, you give them the power to speak up, thereby activating their sense of participation. In addition to incorporating the hospital’s standard surgical safety checklist, another example of how to operationalize quality improvement is to create a “Stop the Line” policy that allows any team member to request clarification or to interrupt a process when they perceive that there is an immediate risk to patient or personnel safety. This policy reinforces the message that it is safe to “speak up.”

Some hospitals have also implemented more formal checklists designed to improve team communication and consistency and, hopefully, reduce complications. A standard checklist requires approximately four minutes to implement and can identify potential surgical problems. Research has shown, however, that an important part of implementing the checklist is the debriefing after the surgery, a part of the process that is commonly either omitted or not performed seriously.

Complexity

The speakers concluded the session by noting that surgical results are infinitely complex and can be beyond the control of physicians. Despite this acknowledgement, surgical teams can put measures in place to mitigate risk. Knowing this makes it clear that surgical teams must implement quality improvement initiatives.

---

Dr. Pullen is a freelance medical writer based in Illinois.