Imhof Malpractice in Surgery

Safety Culture and Quality Management in the Hospital
1. Auflage 2012
ISBN: 978-3-11-027160-7
Verlag: De Gruyter
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, Band 6, 184 Seiten

Reihe: Patient Safety

Tentative estimates suggest that one in ten patients suffers from an adverse event in hospital. In Germany, approx. 1.8 million out of approx. 18 million inpatients suffer from adverse events; 50 percent of these cases are estimated to be avoidable. In the US, nearly 100,000 people die from the consequences of mistreatment.The intensive care units record 1.7 medical errors per patient and day. The most affected disciplines are the operative disciplines, particularly general 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 book deals with complications and 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.

Zielgruppe

Surgeons, Physicians, Clinical Chemists, Clinical Pathologists, Medical Technologists, Research Scientists, Laboratorians and Laboratory Technologists; Laboratory and Healthcare Professionals; Academic Libraries

Autoren/Hrsg.

Imhof, Michael

Weitere Mitwirkende

Blondel, Constantijn

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Public Health, Gesundheitsmanagement, Gesundheitsökonomie, Gesundheitspolitik
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Krankenhausmanagement, Praxismanagement
• Wirtschaftswissenschaften Betriebswirtschaft Management Qualitätsmanagement, Qualitätssicherung (QS), Total Quality Management (TQM)
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Chirurgie

Inhaltsverzeichnis

1;Preface;9
2;Abbreviations;11
3;1 Principles of medical malpractice;15
3.1;1.1 Introduction;15
3.2;1.2 Notes concerning the history of medical malpractice;15
3.3;1.3 Defining malpractice;18
3.4;1.4 Statistical surveys;20
3.5;1.5 Summary;25
4;2 Errors, incidents and complications in general surgery;29
4.1;2.1 Introduction;29
4.2;2.2 Medical errors in laparoscopic cholecystectomy;29
4.2.1;2.2.1 Historical remarks;29
4.2.2;2.2.2 Statistics for medical complications;30
4.2.3;2.2.3 Complications specific to laparoscopic cholecystectomy;31
4.2.4;2.2.4 Surgical procedure, and possible causes of errors;34
4.2.5;2.2.5 Medical malpractice litigation after laparoscopic cholecystectomy;35
4.2.6;2.2.6 Informed consent;39
4.2.7;2.2.7 Real-life examples;39
4.2.8;2.2.8 Summary;41
4.3;2.3 Risks and possible errors related to minimally invasive or laparoscopic surgery;41
4.3.1;2.3.1 Introduction;41
4.3.2;2.3.2 Fundamentals underlying the technical standard and potential errors;41
4.3.3;2.3.3 Real-life examples;45
4.3.4;2.3.4 Summary;47
4.4;2.4 Complications and possible errors in inguinal hernia treatment;47
4.4.1;2.4.1 Introduction;47
4.4.2;2.4.2 Fundamentals of inguinal hernia surgery;48
4.4.3;2.4.3 Informed consent;49
4.4.4;2.4.4 Intra- and postoperative errors and complications;49
4.4.5;2.4.5 Real-life examples;52
4.4.6;2.4.6 Summary;54
4.5;2.5 Complications and errors in the surgical treatment of benign thyroid disorders;55
4.5.1;2.5.1 Introduction;55
4.5.2;2.5.2 Fundamentals of the surgical treatment of struma;55
4.5.3;2.5.3 Informed consent;56
4.5.4;2.5.4 Remarks concerning the surgical technique;56
4.5.5;2.5.5 Technical errors and complications;58
4.5.6;2.5.6 Prospects for new minimally invasive techniques;58
4.5.7;2.5.7 Real-life examples;59
4.5.8;2.5.8 Summary;60
4.6;2.6 Complications and errors arising in the diagnostics and treatment of acute appendicitis;60
4.6.1;2.6.1 Introduction;60
4.6.2;2.6.2 Fundamentals;60
4.6.3;2.6.3 Remarks concerning the surgical technique;62
4.6.4;2.6.4 Errors and complications;63
4.6.5;2.6.5 Real-life examples;64
4.6.6;2.6.6 Summary;64
4.7;2.7 Anastomotic insufficiency in the gastrointestinal tract as a frequent source of malpractice claims;65
4.7.1;2.7.1 Introduction;65
4.7.2;2.7.2 Fundamental concepts;65
4.7.3;2.7.3 Anastomotic leaks in the upper gastrointestinal tract;67
4.7.4;2.7.4 Errors and management of complications;68
4.7.5;2.7.5 Real-life example;69
4.7.6;2.7.6 Anastomotic leakage in the lower gastrointestinal tract – errors and risks;70
4.7.7;2.7.7 Examples of liability issues;71
4.7.8;2.7.8 Summary;73
4.8;2.8 Diagnostic and therapeutical errors in the treatment of acute abdomen;73
4.8.1;2.8.1 Introduction;73
4.8.2;2.8.2 Fundamentals;73
4.8.3;2.8.3 Malpractice claims and complications related to peritonitis and abdominal sepsis;76
4.8.3.1;2.8.3.1 Peritonitis with abdominal sepsis;76
4.8.4;2.8.4 Real-life examples;78
4.8.5;2.8.5 Ileus;80
4.8.6;2.8.6 Malpractice claims related to surgical ileus treatment;82
4.8.7;2.8.7 Real-life examples;82
4.8.8;2.8.8 Mesenteric ischemia;84
4.8.8.1;2.8.8.1 Diagnostic and therapeutic errors related to mesenteric ischemia;84
4.8.9;2.8.9 Real-life example;85
4.8.10;2.8.10 Summary;86
5;3 Retained surgical foreign bodies;107
5.1;3.1 Introduction;107
5.2;3.2 The issue of retained surgical foreign bodies;107
5.3;3.3 Risk management related to the prevention of RSFBs;109
5.4;3.4 Real-life examples;110
5.5;3.5 Summary;111
6;4 Quality management related to wrong-site surgery;115
6.1;4.1 Introduction;115
6.2;4.2 Statistical surveys;115
6.3;4.3 Root cause analysis;117
6.4;4.4 Risk management related to the prevention of WSPEs;119
6.5;4.5 Summary;122
7;5 Towards a preventive safety culture within the hospital;125
7.1;5.1 Introduction;125
7.2;5.2 Safety culture;125
7.3;5.3 Error management as part of quality management in the hospital;126
7.4;5.4 Error classification;128
7.5;5.5 The JCAHO patient safety event taxonomy;129
7.6;5.6 Reporting systems as tools to aid safety culture and risk management;130
7.6.1;5.6.1 CIRS as an aspect of risk management;137
7.7;5.7 Summary;139
8;6 Ethical aspects of an open safety culture: towards a new physician-patient relationship in 21st century medicine;143
9;Bibliography;155
10;Index;185

Über Autor(innen)

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