MONAHRQ Demo - Surgery Infographic

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NEED SURGERY? Make Sure You are Safe as Possible. American health care saves millions of lives through treatment and surgery. However, when things go wrong the effect can be devastating and expensive. EACH YEAR IN THE UNITED STATES about 85,000 patients develop an infection at their surgical site.1 EACH YEAR IN THE UNITED STATES about 70,000 patients accidentally get cut or have a hole poked in an organ that was not part of the surgery.2 Surgery patients are 4 times more likely to die when a surgical mistake happens.

The good news is that doctors, nurses, and hospitals are improving patient safety, especially for surgery. Many hospitals have very good surgical safety ratings, but others don’t. Everyone can do better. Mistakes happen during surgery even in In My State! In one year,3 in our own backyard: C patients had a surgical tool accidentally left in their body.4 In 0.0397% of surgeries, the surgeon accidentally made a hole in the patient’s lung.5 In 0.3234% of surgeries, an organ that was not part of the surgery was cut or punctured accidentally.6 In 0.1288% of surgeries, the surgical wound on on the patient’s stomach or pelvic area split open.7 C patients had unexpected reactions to blood transfusions.8 All of us need to know how often surgical problems happen and if things are getting better.

Fortunately, doctors and nurses know what should be done before, during and after surgery to prevent problems.9 FOR EXAMPLE: Certain types of antibiotics should be given to the patient an hour before surgery, then stopped within 24 hours after surgery. The patient’s temperature should be kept warm and stable. To prevent blood clots, special ‘pressure’ socks should be used to keep blood flowing in the patient’s legs. And the foot of the patient’s bed should be raised. If a catheter was required to help empty a patient's bladder, it should be removed within two days after surgery. Many hospitals take these steps with every surgery patient. But some don’t, and that puts patients at risk.

How safe is the surgery for patients in In My State?10 98.6 received an antibiotic at the right time before surgery.11 98.5 were given the right kind of antibiotic before surgery.12 C had body temperatures managed during and after surgery.13 100 received treatments to prevent blood clots after surgery.14 98.8 who needed a catheter during their procedure had it removed within two days after surgery.15

Tips to Be as Safe as Possible Before, During and After Surgery: DO YOUR HOMEWORK. Understand there are ways to keep patients safe during surgery, and these actions should be taken with every patient, for every surgery. Know the safe surgery ratings for your hospital – visit MONAHRQ Demo Site. TALK ABOUT YOUR SAFETY. Take a copy of this list (and your hospital’s ratings) to talk with your doctor about what to expect when you have surgery. Ask your doctor to use the World Health Organization Safe Surgery Checklist,16 which is proven to reduce the risk of death and complications from surgery.17 HAVE A TEAM ON YOUR SIDE. Bring someone with you to ask questions and listen when you see your doctor or are in the hospital. If people are not paying attention to your concerns, talk to the hospital’s patient advocate service – their job is to help you.

All hospitals are not the same. Some are better overall, some are not so good. Some do well in some areas of care but not in others. Find hospitals that perform best in the areas you care about. Select to Compare Hospitals. Talking with your doctor shows you want to be a partner in your care. It also helps remind your care team to take certain actions to keep you as safe as possible before, during and after surgery.

Footnotes: 1 http://www.ahrq.gov/professionals/quality-patient-safety/pfp/index.html. 2 http://www.ahrq.gov/professionals/quality-patient-safety/pfp/index.html. 3 AHRQ Quality Indicators results as reported in MONAHRQ Demo Site. 4 These evidence-based practices are the subject of measures used in Hospital Compare, developed by the Centers for Medicare and Medicaid Services (CMS) see: http://www.medicare.gov/hospitalcompare/About/What-Is-HOS.html. 5 CMS Hospital Compare measure results as reported in MONAHRQ Demo Site. 6 http://www.safesurg.org/uploads/1/0/9/0/1090835/surgical_safety_checklist_production.pdf. 7 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 8 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 9 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 10 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 11 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 12 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 13 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 14 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 15 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 16 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119. 17 http://www.nejm.org/doi/full/10.1056/NEJMsa0810119.

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