Tomorrow's Health by Steve Klasko, MD, MBA

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Seeking safety doesn’t end with surgery

Sometimes, even in the best hospitals, things go wrong.

Great steps have been taken to reduce the risks of surgery, and many of those have been successful. These days, it’s how health care professionals respond when things go wrong – the ability to rescue – that separates the average from the great, says surgeon and writer Dr. Atul Gawande.

Dr. Gawande, one of the nation’s best and most thoughtful advocates for patient safety, points to a University of Michigan study that emphasizes the problem of “failure to rescue.” Hospitals have similar rates of post-surgery complications, but the best ones recognize those problems and treat them before they get worse.

We have faculty members at our new USF Health Center for Advanced Medical Learning and Simulation preparing surgical teams for exactly these scenarios.  We’re giving them the skills and tools to act when something goes wrong.

For example, one of the most common risks when a woman has a hysterectomy is that her bladder may be injured. Despite this known complication, some studies have shown this to happen in as many as four percent of cases. Surgeons often don’t realize when the injury occurs.

At CAMLS, Dr. Stuart Hart, medical director of the Tampa Bay Research and Innovation Center at CAMLS,  is working to help medical teams recognize this problem. He and Phil Hipol, CAMLS engineering director, just won an inventor’s award for developing the eCath – an innovative device that turns a catheter into an internal stethoscope that can hear sounds inside the body. Dr. Hart is now researching how the eCath can monitor sounds during a hysterectomy, so that surgeons can actually hear the injury.

Another problem is that, even though this type of injury occurs with relative frequency, it happens rarely for any individual obstetrician-gynecologist. So any one doctor may have little experience repairing the problem. That’s why another one of our faculty members, Dr. Mitch Hoffman, is teaching advanced medical students how to repair this type of bladder injury on simulators at CAMLS. If something does go wrong, they’ll have the knowledge and skills to fix the problem immediately.

At CAMLS, we’re teaching the next generation of health professionals to perform surgeries that are safe and free of complication. But we’re also teaching them to be ready – just in case.