Perioperative quality of care and patient safety

The advances in science and technology that enable care for very sick patients, also yield extreme complexity in modern medicine. The cardinal difficulty for healthcare providers is in the execution of care, as it is becoming nearly impossible to choose and apply the best fit for each patient out of all the available diagnostic and treatment modalities. This puts the patient at risk of suboptimal diagnostics, treatment and thus, outcome. This thesis highlights several aspects of modern perioperative patient safety and quality of care such as assessing the safety culture within a department, performing audits, instituting a performance improvement programme, improving medication safety and the benefits of standardisation in order to improve care and patient outcome. Standardisation is a way of dealing with human error in the light of complexity. Standardisation is simplifying a management approach because this is the best approach for most patients and it decreases human error by reducing options in execution of care. Care can be standardised by the use of checklists, guidelines and protocols. This thesis corroborates that the use of checklist and protocols, such as cognitive aids, increases quality of care by improving adherence to best practice. However, as this thesis also points out, these protocols and guidelines should be clear, concise, applicable and well implemented otherwise these tools can actually cause patient harm.