Building a framework for trust: critical event analysis of deaths in surgical care

doi:10.1136/bmj.330.7500.1139

BMJ 2005;330:1139-1142 (14 May), doi:10.1136/bmj.330.7500.1139

Education and debate

Building a framework for trust: critical event analysis of deaths in surgical care

A M Thompson, professor of surgical oncology¹, P A Stonebridge, professor of vascular surgery²

¹ Department of Surgery and Molecular Oncology, University of Dundee, Dundee DD1 9SY, ² Institute for Cardiovascular Research, Ninewells Hospital and Medical School, Dundee DD1 9SY

Correspondence to: A M Thompson. a.m.thompson@dundee.ac.uk

The British public's confidence in doctors and hospitals hasbeen dented in recent years. Use of an independent review ofdeaths before, during, or after surgery reflects an attemptto improve care in this area and may also help to restore thepublic's trust in their health service

The first 150 words of the full text of this article appear below.

Introduction

Events over recent years have undermined patients' and society'strust in clinicians and healthcare institutions. For cliniciansto restore and retain public confidence, they need to show thateffective mechanisms exist for assessing events such as deathand to justify patients' faith in the delivery of care.¹

In the high profile world of cardiac surgery, the audited resultsof key elective procedures may be sufficient to restore confidence.²In wider surgical practice, simple death rates are unlikelyto be sufficient; case-mix (particularly for emergency admissions),institutional, and national issues can jeopardise the interestsof high risk patients.³

Any critical incident review by peers working in the same specialityor subspecialty of patients who die under surgical care shouldtake into account the nature of the patient and the circumstancesof admission. In Scotland, the Scottish Audit of Surgical Mortality(SASM) is a national system of peer review of deaths that . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Western Australian Audit of Surgical Mortality: Robert James Aitken
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Good work, but wrong goal: Neville W Goodman
bmj.com, 20 May 2005 [Full text]
SASM unsuitable for revalidation: Ian G Kestin
bmj.com, 28 May 2005 [Full text]