"The culture has to change to promote people speaking up when they see a safety concern and promote good teamwork," he said.
Makary noted that in many cases the people in the operating room don't know each other and don't even know each other's names. In addition, the medical culture places doctors above nurses and other staff.
"A nurse or a low-level person in the surgical hierarchy may sense that something is not right, but they don't speak up because they are intimidated by the operating room hierarchy," he said.
Makary said that culture needs to change.
"By cutting through that culture and preserving what's good about the hierarchy -- that is, one person needs to make quick decisions, but getting rid of the intimidation, it actually improves safety," he said.
Meanwhile, a study in the October issue of the Archives of Otolaryngology--Head & Neck Surgery, showed that a questionnaire filled out by patients before surgery could help identify patients at risk for complications.
In this study, people prone to obstructive sleep apnea who were found through the questionnaire appeared to have an increased risk of heart, lung and other complications following elective surgery, researchers found.
Dr. Tajender S. Vasu, and colleagues from Thomas Jefferson University Hospital in Philadelphia, concluded that "most patients with obstructive sleep apnea syndrome have undiagnosed conditions and are almost certainly at risk in the perioperative setting. The STOP-BANG questionnaire is a convenient and useful screening tool that appears to reliably identify patients who are at increased risk for postoperative complications."
For more information on patient safety, visit the Joint Commission.
SOURCES: Philip F. Sta
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