Defining and Studying Errors in Surgical Care: A Systematic Review.

Area of Science:

• Medical error analysis
• Surgical safety research
• Healthcare quality improvement

Background:

• The "To Err is Human" report highlighted widespread medical errors.
• Subsequent literature shows significant variability, indicating unknown error prevalence.
• Standardized approaches to error categorization, definition, and study are lacking in surgery.

Purpose of the Study:

• To assess how surgical disciplines categorize, define, and study medical errors.
• To provide recommendations for current practices and future research directions.
• To address the need for standardized methodologies in surgical error research.

Main Methods:

• Systematic literature search of PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials in January 2020.
• Inclusion of studies with Oxford Level of Evidence Level 3 or higher.
• Analysis of 92 studies meeting inclusion criteria, representing over 15 million patients and 162,000 errors.

Main Results:

• Identified 6 broad error categories, 13 distinct error definitions, and 14 different study methodologies across the included studies.
• Significant heterogeneity was found in how errors are categorized, defined, and studied.
• The prevalence of medical errors in surgical disciplines remains unclear due to these inconsistencies.

Conclusions:

• Lack of standardized categorization, definitions, and study methods results in wide variations in reported error prevalence.
• Future research should aim to establish uniform approaches to error identification and reporting.
• Prioritizing immediate error recognition is crucial for minimizing patient harm in surgical settings.