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Spinal Surgery and Patient Safety: A Systems Approach

Dr. Wong is Director, Advanced Center for Spinal Microsurgery, Presbyterian/St. Luke's Medical Center, Denver, CO. Dr. Wong is also Past President, North American Spine Society; Chairman, AAOS Patient Safety Committee; and Chairman, NASS Patient Safety Task Force.

Dr. Wong or the department with which he is affiliated has received research or institutional support from Stryker, Arcus Centerpulse. Dr. Wong or the department with which he is affiliated has received nonincome support (such as equipment or services), commercially derived honoraria, or other non-research–related funding (such as paid travel) from Stryker. Dr. Wong or the department with which he is affiliated serves as a consultant to or is an employee of Stryker.

Reprint requests: Dr. Wong, Denver Spine Center, Suite 4000, 1601 E 19th Avenue, Denver, CO 80218.

In every spinal procedure, identifying the specific patient, proper surgical site, and pathologic lesion for surgical intervention are crucial patient safety concerns. The 1999 Institute of Medicine report "To Err is Human" identified adverse events associated with surgery. Both the American Academy of Orthopaedic Surgeons and the North American Spine Society have had voluntary, systems-based programs in place for several years to address wrong patient, wrong procedure, and wrong site surgery. Beginning July 1, 2004, the Joint Commission on the Accreditation of Healthcare Organizations mandated that hospitals comply with the JCAHO Universal Protocol. In addition to surgical site marking, the protocol incorporates additional factors, such as calling a time out before skin incision to do a final systems check of patient identification, surgical site, records, imaging studies, equipment, and review of preoperative medication.

This article has been cited by other articles:

				D. A. Wong, B. Lewis, J. Herndon, C. Martin Jr., and R. Brooks Patient Safety in North America: Beyond "Operate Through Your Initials" and "Sign Your Site" J. Bone Joint Surg. Am., June 1, 2009; 91(6): 1534 - 1541. [Full Text] [PDF]

				D. A. Wong, J. H. Herndon, S. T. Canale, R. L. Brooks, T. R. Hunt, H. R. Epps, S. S. Fountain, S. A. Albanese, and N. A. Johanson Medical Errors in Orthopaedics. Results of an AAOS Member Survey J. Bone Joint Surg. Am., March 1, 2009; 91(3): 547 - 557. [Abstract] [Full Text] [PDF]