TY - CHAP M1 - Book, Section TI - Quality, Patient Safety, Assessments of Care, and Complications A1 - Makary, Martin A. A1 - Angood, Peter B. A1 - Shapiro, Mark L. A2 - Brunicardi, F. Charles A2 - Andersen, Dana K. A2 - Billiar, Timothy R. A2 - Dunn, David L. A2 - Kao, Lillian S. A2 - Hunter, John G. A2 - Matthews, Jeffrey B. A2 - Pollock, Raphael E. PY - 2019 T2 - Schwartz's Principles of Surgery, 11e AB - Key Points Medical error ranks as the third leading cause of death in the United States when defined to include system errors. One form of medical error is unnecessary or excessive medical care, which represents 21% of medical care administered in the United States. New peer-comparison metrics evaluate appropriateness of surgical care by measuring a physician’s practice pattern among all the physician’s patients benchmarked to the physician’s peers. Judicious opioid prescribing upon discharge after surgery is critical given the magnitude of the opioid crisis. The structure-process-outcome framework within the context of an organization’s culture helps to clarify how risks and hazards embedded within the organization’s structure may potentially lead to error and injure or harm patients. Poor communication contributes to approximately 60% of the sentinel events reported to The Joint Commission. Operating room briefings are team discussions of critical issues and potential hazards that can improve the safety of the operation and have been shown to improve operating room culture and decrease operating room delays. National Quality Forum surgical “never events” include retained surgical items, wrong-site surgery, and death on the day of surgery of a normal healthy patient (American Society of Anesthesiologists Class 1). The most important determinant of malpractice claims against a surgeon is patient rapport, not undertesting. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1175964752 ER -