Risk Management in Surgery and Anesthesia

Abstract

This article reviews the present condition of adverse events related to surgery and anesthesia, errors in operating rooms, and new methods regarding patient safety, and then focuses on risk management including informed consent. According to reports from the United States, Australia, and New Zealand, adverse events (AEs) associated with surgery account for 24-66% of all AEs. Preventable errors that tend to occur in operating rooms are wrong site/wrong patient surgery, retained surgical instruments, and drug errors. In order to prevent these errors, more comprehensive check systems are required. The environment of operating rooms has some characteristics similar to those of aviation. Incident reporting systems and Crew Resource Management (CRM) are examples of the patient safety management systems learned from aviation. On the other hand, informed consent and risk communication are essential for risk management in surgery and anesthesia. Nevertheless, it was revealed that explanations concerning anesthesia varied among hospitals and are not standardized in Japan. Further attention needs to be focused on how to improve informed consent documentation. High-risk industries, such as nuclear and aviation systems might have many ideas to be introduced into clinical risk management, especially in the areas of surgery and anesthesia.