Inpatient Urological Procedures May Reduce Preventable Deaths, Study Shows

A new study published in the British Journal of Urology International (BJUI) shows that a shift in recent years from inpatient to outpatient surgery for common urologic procedures coincides with an increase in patient deaths among certain populations following potentially preventable complications.

The BJUI study, which was published on Aug. 19, looked at approximately 7,725,736 urological surgeries requiring hospitalization in the United States between 1998 and 2010. During that time, the overall odds of mortality decreased slightly, but the odds of failure to rescue (FTR) mortality increased 5 percent each year.

The odds of FTR mortality were associated with older, sicker minority group patients and patients with public insurance, according to the study.

“These strata of high-risk individuals represent ideal targets for process improvement initiatives,” the study authors wrote.

Failure to Rescue Indicates Patient Safety Problems

FTR is a quality-of-care indicator. The study defines it as “death after a complication that was potentially recognizable/preventable.”

The Agency for Healthcare Research and Quality (AHRQ) says that FTR is a type of medical error that “provides a measure of the degree to which providers responded to adverse occurrences that developed on their watch.”

“Failure to rescue describes the inability of a provider or institution to recognize key complications and intervene before mortality,” said study lead author Jesse D. Sammon, a researcher at Henry Ford Hospital’s Vattikuti Urology Institute, according to an article in Science Daily.

“While comparison of overall complications and mortality rates penalizes hospitals treating sicker patients and more complex cases, FTR rates may be a more accurate way to assess safety and quality of care,” Sammon told Science Daily.

‘Suffering from Inadequate or Poorly Applied Safety Measures’

Science Daily reports that FTR as a measure of hospital quality and safety was derived from the 1999 Institute of Medicine report “To Err is Human,” which estimated that there were as many as 98,000 cases of preventable hospital deaths in the U.S. each year. A new estimate published last fall in the Journal of Patient Safety estimates that as many as 440,000 people die in hospitals each year because of medical errors.

The findings by Dr. Sammon’s team suggest that improvements within medical specialties can have an impact on overall patient safety trends.

“These findings also raise the possibility that the care of urologic surgical patients is suffering from inadequate or poorly applied safety measures,” Sammon said.

The attorneys of Morrow Kidman Tinker Macey-Cushman, PLLC represent patients who have been harmed by preventable medical errors in Seattle and across Washington.