Patient Safety?
Press controversy
Checklists
Endoscopy survey
MIRA
Surgical Education

Patient Safety - Ciao!
As the European Working Time Regulations really bite in the summer of 2009 there is increasing concern amongst senior members of the profession that the unintentional effect will be to compromise patient safety as a result of the drastic reduction in the number of hours during which hospital doctors are available to provide clinical services. A letter in the FT in early January followed by a considered response from the Association of Surgeons expressed the views clearly.

 

More recently John Black, the President of our sister College in England has written about his anxieties for patient safety in his newsletter and he will have a chance to meet the Health Secretary in February to articulate the disquiet generally agreed in the surgical departments around the country. The BMA (again) are unsympathetic and unhelpful with their politically correct and mealy mouthed opinions about this situation.
More press controversy
Nurse Practitioners were at the centre of a storm in the papers this month. In focus – private practice. Take this quote from the Times correspondence noted here. It appeared in response to Dr Mark Porter’s article on possibly ditching medical insurance. "Nurses are not doctors. They generally have poorer qualifications. They have shorter and less rigorous training. Nurses are being used to increase the through-put of patients, but at what cost to thoroughness and satisfactory management? If you pay privately, you will always see a medically qualified doctor." Follow the furore here.

Surgical safety checklists

We are back to revisit the check lists which hit the press again this month. The World Health Organization estimates that each year half a million deaths related to surgery could be prevented. Inevitably there is a measure of “correctness” here. There is no guarantee that the introduction of such measures will have the effect observed in the pilot sites. However the pressure will build to introduce a practice like this. In my own operating room we now have a minor checklist practice called a "surgical pause" which corresponds to the WHO “Time Out”. Much checking goes on in the theatre reception area but the new features which can be seen on this link highlight how to do it and indeed how NOT to do it. Actually some aspects of the example seem to be seriously OTT but there is no reason not to adopt the best practice. If you have not seen it already the checklist is here and the implementation manual here.

Endoscopy survey

Some colleagues are keen to have your help with a survey to analyse current practice in lower GI endoscopy training and its compliance with the national guidelines. Endoscopy training is under increasing pressure from waiting times, ever shrinking time for training, and commitment to the national screening program. It is crucial that we have a coherent basis to plan for the future. Participate here.


MIRA

The international Minimally Invasive Robotics Association, strives to facilitate the exchange of information between clinicians and scientists interested in surgical telerobotics and robotics. Membership includes Urologists, Cardiac surgeons, Thoracic surgeons, Gynecologists, General Surgeons, Colon & Rectal Surgeons, Otolaryngologists, and Computer Scientists. The current President is Mehran Anvari who was our guest at the last Glasgow Surgical Forum in November 2008.

 

 

Surgical Education

Various commercial organisatons are committed to supporting a wide variety of surgical education programs. Have a look at the variety of available resources.

Click the respective logos. These resources are specialty specific and cover all branches of surgery.

Till next month

David Galloway