PMID- 29112029
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20230928
IS  - 1549-8425 (Electronic)
IS  - 1549-8417 (Print)
IS  - 1549-8417 (Linking)
VI  - 17
IP  - 3
DP  - 2021 Apr 1
TI  - Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A 
      Qualitative Analysis of Veterans Health Administration Staff Perceptions.
PG  - e177-e185
LID - 10.1097/PTS.0000000000000311 [doi]
AB  - OBJECTIVES: Little is known about patient safety risks in outpatient surgery. 
      Inpatient surgical adverse events (AEs) risk factors include patient- (e.g., 
      advanced age), process- (e.g., inadequate preoperative assessment), or 
      structure-related characteristics (e.g., low surgical volume); however, these 
      factors may differ from outpatient care where surgeries are often elective and in 
      younger/healthier patients. We undertook an exploratory qualitative research 
      project to identify risk factors for AEs in outpatient surgery. METHODS: We 
      developed a conceptual framework of patient, process, and structure factors 
      associated with surgical AEs on the basis of a literature review. This framework 
      informed our semistructured interview guide with (1) open-ended questions about a 
      specific outpatient AE that the participant experienced and (2) outpatient 
      surgical patient safety risk factors in general. We interviewed nationwide 
      Veterans Health Administration surgical staff. Results were coded on the basis of 
      categories in the conceptual framework, and additional themes were identified 
      using content analysis. RESULTS: Fourteen providers representing diverse surgical 
      roles participated. Ten reported witnessing an AE, and everyone provided input on 
      risk factors in our conceptual framework. We did not find evidence that patient 
      race/age, surgical technique, or surgical volume affected patient safety. 
      Emerging factors included patient compliance, postoperative patient 
      assessments/instruction, operating room equipment needs, and safety culture. 
      CONCLUSIONS: Surgical staff are familiar with AEs and patient safety problems in 
      outpatient surgery. Our results show that processes of care undertaken by 
      surgical providers, as opposed to immutable patient characteristics, may affect 
      the occurrence of AEs. The factors we identified may facilitate more targeted 
      research on outpatient surgical AEs.
CI  - Copyright (c) 2017 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Mull, Hillary J
AU  - Mull HJ
FAU - Rosen, Amy K
AU  - Rosen AK
FAU - Charns, Martin P
AU  - Charns MP
FAU - Itani, Kamal M F
AU  - Itani KMF
FAU - Rivard, Peter E
AU  - Rivard PE
AD  - Healthcare Administration, Sawyer Business School Suffolk University, Boston, MA.
LA  - eng
GR  - IK2 HX001520/HX/HSRD VA/United States
GR  - IK6 HX002839/HX/HSRD VA/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Patient Saf
JT  - Journal of patient safety
JID - 101233393
SB  - IM
MH  - Ambulatory Surgical Procedures
MH  - Humans
MH  - *Outpatients
MH  - Patient Safety
MH  - Perception
MH  - *Veterans Health
PMC - PMC8445239
MID - NIHMS1739451
COIS- The authors disclose no conflict of interest.
EDAT- 2017/11/08 06:00
MHDA- 2021/11/25 06:00
PMCR- 2021/09/16
CRDT- 2017/11/08 06:00
PHST- 2017/11/08 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2017/11/08 06:00 [entrez]
PHST- 2021/09/16 00:00 [pmc-release]
AID - 01209203-202104000-00023 [pii]
AID - 10.1097/PTS.0000000000000311 [doi]
PST - ppublish
SO  - J Patient Saf. 2021 Apr 1;17(3):e177-e185. doi: 10.1097/PTS.0000000000000311.