Communication and checklists may lead to fewer surgical complications

An article published in the December issue of the Journal of the American College of Surgery found decreases in some postoperative complications when surgical teams were trained in communication and to use a procedure check list.

Medscape: Checklists, Communication May Reduce Surgical Complications
Training surgical teams in communication and using a procedure checklist before, during, and after surgery may significantly decrease 30-day postoperative complications such as surgical site infections and bleeding requiring transfusions, according to a study conducted at 2 Connecticut medical centers. Lindsay A. Bliss, MD, general surgery resident at the University of Connecticut Health Center, Farmington, and colleagues report their results in an article, published in the December issue of the Journal of the American College of Surgery. The investigators compared the outcomes for 3 sets of surgeries: 73 in which the surgical team had participated in communications training and used a surgical checklist, 246 in which the team had not received the training but used a checklist, and 2079 that were drawn from the American College of Surgeons National Surgical Quality Improvement Program database for use as a baseline comparator (Hand, 12/7).

Meanwhile, a news report from the Los Angeles Times details how a heart surgeon caused five patients to contract infections during valve-replacement surgeries -

Los Angeles Times: Surgeon Infected Patients During Heart Procedure, Cedars-Sinai Admits
A heart surgeon at Cedars-Sinai Medical Center unwittingly infected five patients during valve replacement surgeries earlier this year, causing four of the patients to need a second operation. The infections occurred after tiny tears in the latex surgical gloves routinely worn by the doctor allowed bacteria from a skin inflammation on his hand to pass into the patients' hearts, according to the hospital. The patients survived the second operation and are still recovering, hospital officials said (Gorman, 12/8).

Also in the news, a new study finds survival chances increase when patients enter the hospital via the emergency room during slower periods --

Medscape: Crowded EDs Associated With Higher Risk For Inpatient Death
Patients admitted to hospitals via crowded emergency departments (EDs) may be more likely to die in the hospital than similar patients admitted during slow periods, according to a study published online December 5 in the Annals of Emergency Medicine. Findings also suggest that ED crowding is associated with a slight increase in length of stay and a 1 percent cost increase. Benjamin C. Sun, MD, MPP, associate professor of emergency medicine, Oregon Health & Science University, Portland, and colleagues studied the admission records from 995,379 ED visits by adults to 187 California acute-care hospitals in 2007, focusing on periods of ED crowding, distinguished by the need to divert ambulances from the hospital. The data were adjusted for case mix, patient demographics, comorbidities, and primary discharge diagnosis (Laidman, 12/7).