Quality Improvment Initiatives in Surgery: Challenges and Way Forward

Abstract

Half a million people died each year due to medication error said by Abdul Latif Shaikh president of the Pakistan Society of Health-System Pharmacists (PSHP) at a press conference in Karachi Press Club in 2017³. More than 200 million surgeries performed each year in the world and recent studies implored the high rate of an adverse event, despite certain patient safety initiatives, in recent past.   The incidence of surgical errors is the errors that occurred before and after any surgical intervention during Peri-Operative care rather than a technical surgical mistake.  These include but are not limited to, lack of communication amongst the surgical team, care providers, patients, and their families, delay in diagnosis or failure to diagnose, and delay in treatment or failure to treat^5.

Thus, we need to formulate the processes ensuring the multiple layers of defense (Swiss Cheese Model) for surgical care, to ensure a proper defense mechanism against the potential harm that can cause by an error. Errors in the system are like an opportunistic pathogen in the body. As the immune system of the body gets weaker, the pathogen wins. Similarly, as the processes of the organization lack its defense the error wins.

In front of the number of research articles and as working Quality Professionals we would suggest that the government under the public and private partnership should develop a separate department for Surgical Improvement in Pakistan. This department will focus on developing/adapting key surgical measures, analyzing and published data on positive outcomes procedure-wise, consultant wise and hospital wise and publish them for the public to choose from the best possible care available to them.