Principles of Perioperative Safety and Efficiency

Jamal J. Hoballah, MD, MBA, FACS, Department of Surgery, American University of Beirut Medical Center, Beirut, LebanonHaytham M. A. Kaafarani, MD, MPH, FACS, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, MA, USAGeorgios Tsoulfas, MD, PhD, FACS, FICS, Department of Transplantation Surgery, Aristotle University School of Medicine, Thessaloniki, Greece

• Part I. Perioperative Optimization.- Human Factors and Principles of Patient Safety: The James Reason Model.- Preoperative Testing in the Era of Cost-Containment: Is There a Limit?- Preventing Never Events: Checklist, Timeouts, Debriefings, and Skin Marking.- Reducing Perioperative Medication Errors: How to Build Safer Systems.- Managing the Patient on Antiplatelet, Anticoagulation, Beta Blockers, Angiotensin Converting Enzyme Inhibitors, Angiotensin-Receptors Blockers: The Anesthesia Perspective.- Reducing Surgical Site Infections.- Perioperative Deep Vein Thrombosis Prophylaxis.- Handling Pacemakers and Implantable Cardioverter Defibrillators in the Operating Room.- Traffic, Attire, and Distractions in the OR.- Handling Surgical Specimens to Decrease Errors in Pathology.- Blood Transfusion Safety in the Operating Room.- Part II. System Design and Improvement.- Detecting and Reporting Errors, Complications and Adverse Events.- Simulation Technical Training to Improve Safety in the OR.-. Teamwork and Communication Simulation to Improve Safety in the OR.- Implementing Crew Resources Management Principles to Improve Perioperative Safety.- Peer Review of Perioperative Adverse Events.- Enhanced Recovery after Surgery Protocols.- Peer Review of Perioperative Adverse Events.- “I Can’t Ventilate!’’ Intraoperative Anesthesia Safety Events and Airway Management.- “Don’t Yell at Me!” Disruptive Behavior in the OR.- “Code Red!” Preventing and Managing Fire and Smoke Hazards in the OR.- “I Got Stuck!” Blood Exposure in the OR—Prevention and Management of Sharp Injuries and Infectious Disease Exposure.- “I’m Missing a Sponge!” New Techniques in the Prevention of Foreign Body Retention.- Principles of Perioperative Safety and Efficiency on the Global Stage.- The Role of the American College of Surgeons in Advancing Perioperative Safety and Efficiency.