Plastic surgeons need to be aware of new approaches–and vigilant about following basic techniques–for preventing errors and protecting patient safety in the operating room, according to a special article in the November issue of Plastic and Reconstructive Surgery.

“As the importance of teamwork becomes more evident, clear communication skills preoperatively, intraoperatively and postoperatively become equally critical,” write Samuel O. Poore, M,D., a plastic surgeon at the University of Wisconsin and colleagues.

Simple steps such as better communication, adopting crew resource management approach and basic hygiene all go a long way toward preventing errors and improving patient safety.

Studies have shown that communication breakdowns are a major contributor to medical errors. Crew Resource Management (CRM)–an approach borrowed from aviation–is emerging as a means of improving safety in health care as well. “Since being widely introduced into the airline industry, CRM has been shown to improve performance, safety, communication, morale and decrease accidents related to crew error,” the authors write. Initial experience suggests that CRM can also improve safety in medical settings–including the operating room.

One practical approach introduced at several institutions is briefing/debriefing protocols. This involves discussing the surgical case or procedure before and afterwards–creating a “shared mental model” that sets the tone among the surgical team. CRM provides a safe setting for all members of the surgical team–regardless of rank–to express opinions and voice concerns.

One recent study estimated that there are between 1,300 and 2,700 cases of “wrong site and wrong person surgery”–or near-miss events–each year in the US. Plastic surgeons need to be aware of the recently introduced “universal protocol” for preventing wrong-site surgery. The protocol specifies routines for verifying the correct site, person, and operation before every surgical procedure–including marking the incision site while the surgeon is present and the patient is awake. Improper patient positioning can result in problems like nerve injuries and pressure sores.

[Source: Plastic and Reconstructive Surgery]