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Malpractice in Surgery Safety Culture and Quality Management in the Hospital

:	Michael Imhof
:	Malpractice in Surgery Safety Culture and Quality Management in the Hospital
:	Walter de Gruyter GmbH& Co.KG
:	9783110271607
:	1
:	CHF 31.60
:

:	Medizin
:	English

:	184
:	Wasserzeichen
:	PC/MAC/eReader/Tablet
:	PDF

< PAN lang=EN>

The intensive care units record 1.7 medical errors per patient and day. The most affected disciplines are the operative disciplines, particularly surgery. Medical errors mainly occur when the indication for surgery is being made, during surgery and post-surgery. Suspicious oncological diagnostic results and post-operative complications are also often ignored.

This bookdeals with typical medical errors in surgery. It shows solutions and ways of dealing effectively with these errors and how to establish an efficient security management system.

< >Michael Imhof, Office for Medical and Scientific Expert Assessments, Würzburg, Germany.

	Preface	9
	Abbreviations	11
	1 Principles of medical malpractice	15
	1.1 Introduction	15
	1.2 Notes concerning the history of medical malpractice	15
	1.3 Defining malpractice	18
	1.4 Statistical surveys	20
	1.5 Summary	25
	2 Errors, incidents and complications in general surgery	29
	2.1 Introduction	29
	2.2 Medical errors in laparoscopic cholecystectomy	29
	2.2.1 Historical remarks	29
	2.2.2 Statistics for medical complications	30
	2.2.3 Complications specific to laparoscopic cholecystectomy	31
	2.2.4 Surgical procedure, and possible causes of errors	34
	2.2.5 Medical malpractice litigation after laparoscopic cholecystectomy	35
	2.2.6 Informed consent	39
	2.2.7 Real-life examples	39
	2.2.8 Summary	41
	2.3 Risks and possible errors related to minimally invasive or laparoscopic surgery	41
	2.3.1 Introduction	41
	2.3.2 Fundamentals underlying the technical standard and potential errors	41
	2.3.3 Real-life examples	45
	2.3.4 Summary	47
	2.4 Complications and possible errors in inguinal hernia treatment	47
	2.4.1 Introduction	47
	2.4.2 Fundamentals of inguinal hernia surgery	48
	2.4.3 Informed consent	49
	2.4.4 Intra- and postoperative errors and complications	49
	2.4.5 Real-life examples	52
	2.4.6 Summary	54
	2.5 Complications and errors in the surgical treatment of benign thyroid disorders	55
	2.5.1 Introduction	55
	2.5.2 Fundamentals of the surgical treatment of struma	55
	2.5.3 Informed consent	56
	2.5.4 Remarks concerning the surgical technique	56
	2.5.5 Technical errors and complications	58
	2.5.6 Prospects for new minimally invasive techniques	58
	2.5.7 Real-life examples	59
	2.5.8 Summary	60
	2.6 Complications and errors arising in the diagnostics and treatment of acute appendicitis	60
	2.6.1 Introduction	60
	2.6.2 Fundamentals	60
	2.6.3 Remarks concerning the surgical technique	62
	2.6.4 Errors and complications	63
	2.6.5 Real-life examples	64
	2.6.6 Summary	64
	2.7 Anastomotic insufficiency in the gastrointestinal tract as a frequent source of malpractice claims	65
	2.7.1 Introduction	65
	2.7.2 Fundamental concepts	65
	2.7.3 Anastomotic leaks in the upper gastrointestinal tract	67
	2.7.4 Errors and management of complications	68
	2.7.5 Real-life example	69
	2.7.6 Anastomotic leakage in the lower gastrointestinal tract – errors and risks	70
	2.7.7 Examples of liability issues	71
	2.7.8 Summary	73
	2.8 Diagnostic and therapeutical errors in the treatment of acute abdomen	73
	2.8.1 Introduction	73
	2.8.2 Fundamentals	73
	2.8.3 Malpractice claims and complications related to peritonitis and abdominal sepsis	76
	2.8.3.1 Peritonitis with abdominal sepsis	76
	2.8.4 Real-life examples	78
	2.8.5 Ileus	80
	2.8.6 Malpractice claims related to surgical ileus treatment	82
	2.8.7 Real-life examples	82
	2.8.8 Mesenteric ischemia	84
	2.8.8.1 Diagnostic and therapeutic errors related to mesenteric ischemia	84
	2.8.9 Real-life example	85
	2.8.10 Summary	86
	3 Retained surgical foreign bodies	107
	3.1 Introduction	107
	3.2 The issue of retained surgical foreign bodies	107
	3.3 Risk management related to the prevention of RSFBs	109
	3.4 Real-life examples	110
	3.5 Summary	111
	4 Quality management related to wrong-site surgery	115
	4.1 Introduction	115
	4.2 Statistical surveys	115
	4.3 Root cause analysis	117
	4.4 Risk management related to the prevention of WSPEs	119
	4.5 Summary	122
	5 Towards a preventive safety culture within the hospital	125
	5.1 Introduction	125
	5.2 Safety culture	125
	5.3 Error management as part of quality management in the hospital	126
	5.4 Error classification	128
	5.5 The JCAHO patient safety event taxonomy	129
	5.6 Reporting systems as tools to aid safety culture and risk management	130
	5.6.1 CIRS as an aspect of risk management	137
	5.7 Summary	139
	6 Ethical aspects of an open safety culture: towards a new physician-patient relationship in 21st century medicine	143
	Bibliography	155
	Index	185