Articles Offer Insight on Systems-based Quality Improvement for Neurosurgical Procedures

The November issue of Neurosurgical Focus is dedicated to lessening the number and severity of adverse events surrounding neurosurgical intervention for a variety of disorders. Guest editors Alexander Khalessi, MD (University of California, San Diego); James Forrest Calland, MD (University of Virginia); Gabriel Zada, MD (University of Southern California); and Michael Y. Wang, MD, FAANS (University of Miami Health System), selected 16 articles on systems-based quality improvement for neurosurgical procedures. They are divided into four major subtopics: efforts to improve preoperative, intraoperative and postoperative processes; data validating those efforts in individual institutions; clinical issues and environments particular to neurosurgery as a whole; and issues specific to subspecialty surgeries. Authors from the U.S., Germany, Italy, Taiwan and the U.K. made contributions to the issue.

The first article in the collection sets up the general problem of adverse events and poses strategies for how to deal with them. Judith Wong, MD, and colleagues reviewed the patterns and frequencies of neurosurgery-related adverse events. They found six categories related to adverse events: surgical technique; perioperative medical management; protocol adherence; preoperative optimization; technology; and communication. On the basis of their review, these authors make five recommendations: a national registry for outcome data and monitoring; standardization of specialized equipment; more widespread subspecialization and regionalization of care; establishment of evidence-based guidelines and protocols; and adoption of the World Health Organization Surgical Safety Checklist within the neurosurgical operating room.

For more information, click here to read the full release.