Surgical care is not as reliable as it should be. Worldwide, about 10% of patients are inadvertently harmed while receiving treatment in the healthcare system. In recent years, observational studies have documented the large burden of inadvertent harm and mortality from the effects of modern healthcare (see references 1 and 2)

Research into the causes of this serious problem has focused largely on failures in communication and teamwork between healthcare staff, and on faults in the system of work which make it inherently unsafe (references 3 – 9).

 QRSTU Objectives and activities

This research group aims to develop understanding of the problems of safety and reliability in healthcare and to investigate and perfect potential solutions. We are therefore taking part in on-going work to develop the tools needed for this relatively new field of research; this includes taxonomies, definitions and importantly, new measures and scales. Our emphasis however is on studies of interventions which may improve quality, reliability and safety, and we have taken a strategic decision to study and adapt methods from high reliability organisations in other spheres of work as one of our main methods for developing these.

For more information on the group, and the ongoing research projects, please see:

Quality, Reliability, Safety and Teamwork Unit

References

1. Kohn LT, Corrigan JM and Donaldson MS. To Err is human: building a safer health system. Institute of Medicine, National Academies Press, Washington DC, 1999

2. Donaldson L. An organisation with a memory. Clin Med. 2002 Sep-Oct;2(5):452-7.

3. Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ. 2001 Mar 3;322(7285):517-9.

4. Sari AB, Sheldon TA, Cracknell A, Turnbull A, Dobson Y, Grant C, Gray W, Richardson A. Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. Qual Saf Health Care. 2007 Dec;16(6):434-9.

5. Leape LL. Error in Medicine. JAMA 1994; 272(23):1851-1857.

6. Rutherford W. Aviation safety: a model for health care? Qual Saf Health Care 2003;12:162-163

7. Lingard L, Espin S, Whyte S, Regehr G, Baker GR, Reznick R, Bohnen J, Orser B, Doran D, Grober E. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004 Oct;13(5):330-4

8. Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM. A prospective study of patient safety in the operating room. Surgery. 2006 Feb;139(2):159-73.

9. Makary MA, Sexton JB, Freischlag JA, Holzmueller CG, Millman EA, Rowen L, Pronovost PJ. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. J Am Coll Surg. 2006 May;202(5):746-52.