5 Ways to Improve Outcomes for Neurosurgery Patients

A group of researchers led by Atul A. Gawande, MD, MPH, of Brigham and Women's Hospital in Boston, have outlined five strategies to improve outcomes for patients undergoing neurosurgical procedures.

The researchers analyzed data and determined six factors contributing to neurosurgical adverse events: surgical technique, perioperative medical management, nonadherence to protocol, preoperative optimization, technology and communication. Based on an analysis of these factors, the researchers then detailed five ways healthcare providers can prevent neurosurgical adverse events:


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1. Adopt process and outcome monitoring. Researchers noted the American Association of Neurological Surgeons' recent launch of NeuroPoint Alliance and the National Neurosurgery Quality and Outcomes Database. This national registry could help neurosurgeons with benchmarking and quality improvement initiatives.

2. Improve subspecialization and regionalization in neurosurgery. Regionalization and subspecialization would help prevent adverse events that are unique to certain procedures and techniques. Development of Centers of Excellence in neurosurgery could boost these efforts.

3. Adhere to established guidelines and protocols. Neurosurgeons must collaborate to establish and implement evidence-based guidelines and protocols for neurosurgery. Doing so could mitigate the risk of variation during surgery and drive down the incidence of adverse events.

4. Standardize equipment. Global standardization of spine devices and other technology could help reduce variation and human error.

5. Implement the WHO Surgical Safety Checklist. Communication failures are a frequent cause of neurosurgical adverse events. Implementation of the WHO Surgical Safety Checklist, in addition to follow-up audits and monitoring, can facilitate and improve surgical team communication.

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