Clinical consequences of feedback on ear surgery: the continuous recording of adverse events and complications with regard to reducing the number of surgeons who perform otosclerosis surgery
| Autor: | Jan Rombout, Bernard K. H. Pauw, W. J. Fokkens, Bert G.A. van Zanten |
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| Přispěvatelé: | Ear, Nose and Throat, Otorhinolaryngology and Head and Neck Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Severity of Illness Index Feedback Postoperative Complications Outcome Assessment Health Care medicine Humans Major complication Prospective Studies Practice Patterns Physicians' Prospective cohort study Adverse effect Child Aged Quality of Health Care Aged 80 and over business.industry General Medicine Middle Aged medicine.disease Surgery Stapes Mobilization Otosclerosis Otorhinolaryngology Continuous recording Female Neurosurgery Clinical Competence business Complication |
| Zdroj: | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS), 259(7), 351-361. Springer Verlag European Archives of Oto-Rhino-Laryngology, 259, 351-361. Springer-Verlag |
| ISSN: | 0937-4477 |
| DOI: | 10.1007/s00405-002-0457-y |
| Popis: | Electronically stored data may be used to generate feedback overviews. This paper describes a method for establishing a picture of ear surgery complications. In this prospective study, the working definition of adverse events and complications is "incidents that are not intrinsic to the surgical procedure and that have a potential or actual negative effect on surgical outcome or postoperative morbidity". A simple method is used to categorise otologic adverse events and complications. This scale varies from adverse events (grade A) to death (grade D). All adverse events and complications in ear surgery that met this definition were documented electronically as part of continuous follow-up between 1 July 1992 and 30 June 1999. In the first 3 years, 1,009 ear operations were performed, and in 51 (5%) of them, adverse events or complications were noted during or after surgery. There were 30 (3%) grade A (adverse events), 18 (2%) grade B (minor complications), 3 (0.3%) grade C (major complications) and no grade D complications. Otosclerosis surgery was evaluated additionally, because halfway through a 7-year period, the number of surgeons was changed. Only three experienced, senior members of staff were involved, and inexperienced residents no longer were allowed to perform this kind of surgery. The reduction of surgeon numbers did indeed improve the outcome of the stapes surgery. Our results were comparable to the literature. This monitoring of outcome-results in relation to changes in care can be seen as a study of care quality. A review of this kind links daily clinical practice to the literature and induces an improvement in quality. |
| Databáze: | OpenAIRE |
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