Abstract
Background:Medical errors cause nearly 100,000 deaths per year and cost billions of dollars annually. In order to rationally develop and institute programs to mitigate errors, the relative frequency and costs of different errors must be documented. This analysis will permit the judicious allocation of scarce healthcare resources to address the most costly errors as they are identified.Methods:Here, we provide a systematic review of the neurosurgical literature describing medical errors at the departmental level. Eligible articles were identified from the PubMed database, and restricted to reports of recognizable errors across neurosurgical practices. We limited this analysis to cross-sectional studies of errors in order to better match systems-level concerns, rather than reviewing the literature for individually selected errors like wrong-sided or wrong-level surgery.Results:Only a small number of articles met these criteria, highlighting the paucity of data on this topic. From these studies, errors were documented in anywhere from 12% to 88.7% of cases. These errors had many sources, of which only 23.7-27.8% were technical, related to the execution of the surgery itself, highlighting the importance of systems-level approaches to protecting patients and reducing errors.Conclusions:Overall, the magnitude of medical errors in neurosurgery and the lack of focused research emphasize the need for prospective categorization of morbidity with judicious attribution. Ultimately, we must raise awareness of the impact of medical errors in neurosurgery, reduce the occurrence of medical errors, and mitigate their detrimental effects.
Highlights
Medical errors cause nearly 100,000 deaths per year and cost billions of dollars annually
Preventable medical errors lead to the death of up to 98,000 Americans annually and cost the U.S economy over $17 billion per year.[9,16]
A PubMed search was performed on the terms “medical error,” “surgical error,” “patient safety,” or “quality improvement” in conjunction with the terms “neurosurgery” or “neurological surgery.”
Summary
We provide a systematic review of the neurosurgical literature describing medical errors at the departmental level. Eligible articles were identified from the PubMed database, and restricted to reports of recognizable errors across neurosurgical practices. We limited this analysis to cross‐sectional studies of errors in order to better match systems‐level concerns, rather than reviewing the literature for individually selected errors like wrong‐sided or wrong‐level surgery. Articles were reviewed by the authors and excluded if they limited their discussion to only a single surgical procedure, only a single error, or did not discuss identifiable medical errors. Articles describing adverse events that we could not identify as preventable or nonpreventable were excluded. The purpose of these limitations was to place focus on the systems level of errors. The type and frequency of errors were abstracted
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