Surgical performance, human error and patient safety in urological surgery

SummaryResearch has shown that about 10% of hospitalized patients suffer an adverse event as a result of the care that is delivered to them. In aiming to reduce the incidence of adverse events, a better understanding of the determinants of and contributors to surgical processes and outcomes is of paramount importance. On studying the literature some authors have focused on the degree of avoidable harm while others have focused on the development of measures that assess technical as well as non-technical skill in surgeons and surgical teams. This paper aims to review these developments and examine their existing applications and potential applicability to urological surgery. We then present a “systems approach” to surgical performance and apply it to urological surgery and conclude with immediate clinical applications of the systems approach and future directions for relevant surgical research.