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Medicopolitical Digest

More teamwork needed to improve patient careMPs expose Quarry House “disaster”Hospitals told not to close emergency departmentsBMA calls for confidential firearms hotlineRural pharmacists win test caseBMA rejects terms for public health registrars

BMJ 1996; 313 doi: (Published 07 December 1996) Cite this as: BMJ 1996;313:1489
  1. Linda Beecham

    More teamwork needed to improve patient care

    Surgical operations should not be started unless care services are available, and hospitals admitting urgent and emergency cases must have staffed operating theatres available on a 24 hour basis. This is one of the recommendations of the fifth report by the National Confidential Enquiry into Perioperative Deaths, which looked at 20 000 deaths occurring between April 1993 and March 1994.

    The report says that there is still room for improvement in consultation, collaboration, and teamwork between anaesthetists, surgeons, and physicians. It emphasises the importance of better communication between the medical specialties involved, and urges clinicians, pathologists, and coroners to improve their working relationships.

    The report recommends that protocols for treating common conditions should be applied more widely to elective and emergency admissions; the perioperative management of the elderly and unfit should be improved; trusts should implement systems to improve the retention and availability of all notes and records of clinical activity; and there should be more research on thromboembolism prophylaxis.

    The chairman of the inquiry, Professor John Blandy, said that the number of deaths had to be balanced against the 3.5m operations performed each year. “There has been a quite noticeable improvement since we started these reports in 1987.”

    More than 400 of the cases analysed involved elderly people with a broken thighbone. The report cites 10 cases in which its advisers “doubted the wisdom of the decision to operate.” In each case the patient …

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