Use of Unsolicited Patient Observations to Identify Surgeons With Increased Risk for Postoperative Complications

作者：William O. Cooper, Oscar Dean Guillamondegui, Oscar Joe Hines, Charles Scott Hultman, Rachel Rapaport Kelz, Perry Shen, David Alan Spain, John F. Sweeney, Ilene N. Moore, Joseph R. Hopkins, Ira Horowitz, Russell M. Howerton, J. Wayne Meredith, Nathan O. Spell, Patricia Sullivan, Henry John Domenico, James W. Pichert, Thomas F. Catron, Lynn E. Webb, Roger Roman Dmochowski, Jan Karrass, Gerald B. Hickson · 发表于：JAMA Surgery · 年份：2017 · DOI：10.1001/jamasurg.2016.5703 · 被引用次数：121 · 研究领域：Medical Malpractice and Liability Issues、Patient Safety and Medication Errors、Patient-Provider Communication in Healthcare

Importance: Unsolicited patient observations are associated with risk of medical malpractice claims. Because lawsuits may be triggered by an unexpected adverse outcome superimposed on a strained patient-physician relationship, a question remains as to whether behaviors that generate patient dissatisfaction might also contribute to the genesis of adverse outcomes themselves. Objective: To examine whether patients of surgeons with a history of higher numbers of unsolicited patient observations are at greater risk for postoperative complications than patients whose surgeons generate fewer such unsolicited patient observations. Design, Setting, and Participants: This retrospective cohort study used data from 7 academic medical centers participating in the National Surgical Quality Improvement Program and the Vanderbilt Patient Advocacy Reporting System from January 1, 2011, to December 31, 2013. Patients older than 18 years included in the National Surgical Quality Improvement Program who underwent inpatient or outpatient operations at 1 of the participating sites during the study period were included. Patients were excluded if the attending surgeon had less than 24 months of data in the Vanderbilt Patient Advocacy Reporting System preceding the date of the operation. Data analysis was conducted from June 1, 2015, to October 20, 2016. Exposures: Unsolicited patient observations for the patient's surgeon in the 24 months preceding the date of the operation. Main Outcomes and Measu...