Postoperative Monitoring for Clinical Deterioration

Abstract

Approximately 40 million surgeries take place annually in the United States, many of them requiring overnight or lengthier postoperative stays from the 5,000 or more hospitals that comprise our acute healthcare system. Throughout the twentieth century patients assumed that being surrounded by well trained nurses and physicians in hospitals guaranteed safety. That bubble burst with the Institute of Medicine’s 1999 report: To Err Is Human, followed closely by its 2001 report: Crossing the Quality Chasm. For the first time, the US public was put on notice regarding the high likelihood of mistakes and error occurring while hospitalized. Nearly all aspects of hospital care since then have been closely scrutinized and re-engineered to optimize risk reduction, except for one. This remaining aspect comprises the risk of having unexpected serious complications, especially immediately following surgery while recovering on hospital general care floors (GCF). This chapter entitled: “Postoperative Monitoring for Clinical Deterioration, Postoperative Care and Managing Rapidly Evolving Clinical Cascades,” explores in detail this remaining problem with its readers, taking the time to explain in clear, easily understood prose: Why these problems continue occurring What has and has not been done about it, and why How care will be transformed in the near future to prevent these problems What can be done immediately with current resources to begin a safe transition.