Principles of risk management in surgery departments

Abstract

Objectives: Surgical procedures aim at preserving human life and improving life quality. However, there are many poten- tial risk sources that can cause serious harm to patients. For centuries, managers believed that the technical competence of the surgeon is the only key to a successful surgery. But over the past decade, risks have been considered in terms of process-based safety procedures, teamwork and inter departmental communication. This study aims to determine how the process-biased surgical risk management should be done in terms of project management tool named activity breakdown structure (ABC). Methods: This study was conducted in two stages. First, literature review and meeting with professors was done to de- termine principles and framework of surgical risk management. Responsible teams for surgical patient journey were then involved in subsequent meetings to develop the process-biased surgical risk management. This study is a qualitative research in which the inductive approach is used on focus groups. Sampling was performed to achieve representative- ness through intensity sampling biased on experience and seniority. Context analysis of interviews and consensus themes extracted from focus discussion group meetings discussion was the analysis tool. Results: We structured the patient journey process in five main phases, 24 activities and 108 tasks. Then, the responsible teams were involved, and the transposition and allocated places for performing were chosen. Because of their importance, some activities and task themes such as patient identification and records review were repeated in each phase. Conclusions: Risk management of surgical departments is significant as this is typically the hospital facility with the both the highest cost and revenue. Communication between the surgical team and other clinical teams outside the surgery department through process-biased perspective could improve the safety of patients.