Errores en cirugía: estrategias para mejorar la seguridad quirúrgica / Errors in surgery: strategies to improve surgical safety

ABSTRACT

Surgery is an extreme experience for both patient and surgeon. The patient has to be rescued from something so serious that it may justify the surgeon to violate his/her integrity in order to resolve the problem. Nevertheless, both physician and patient recognize that the procedure has some risks. Medical errors are the 8th cause of death in the U.S., and malpractice can be documented in >50% of the legal prosecutions in Mexico. Of special interest is the specialty of general surgery where legal responsibility can be confirmed in >80% of the cases. Interest in mortality attributed to medical errors has existed since the 19th century; clearly identifying the lack of knowledge, abilities, and poor surgical and diagnostic judgment as the cause of errors. Currently, poor organization, lack of team work, and physician/ patient-related factors are recognized as the cause of medical errors. Human error is unavoidable and health care systems and surgeons should adopt the culture of error analysis openly, inquisitively and permanently. Errors should be regarded as an opportunity to learn that health care should to be patient centered and not surgeon centered. In this review, we analyze the causes of complications and errors that can develop during routine surgery. Additionally, we propose measures that will allow improvements in the safety of surgical patients.