tag:blogger.com,1999:blog-3537002903624765538.post8305097975823337079..comments2023-09-29T09:06:27.450+01:00Comments on Success in Healthcare: COMPLICATIONS OR HARM AND THEIR IMPACTSSuccess in Healthcarehttp://www.blogger.com/profile/00598131849595828217noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-3537002903624765538.post-73625443871201463712012-02-12T19:36:38.473+00:002012-02-12T19:36:38.473+00:00Thank you Vikas for your thoughtful comments.
My v...Thank you Vikas for your thoughtful comments.<br />My view is that 40% to 60% of the complications that we see could be avoided by doing the stuff that we know that we should be doing. So there are a number of predictable and avoidable complications.<br />There are a number of places who get 0%VAP. I have written about 0% parastomal hernia rate (okay it was only 100 patients) http://successinhealthcare.blogspot.com/2011/10/0-complication-rate-procedure-is-it.html<br />My point is that we should create systems to enable the least possible harm from healthcare.Success in Healthcarehttps://www.blogger.com/profile/00598131849595828217noreply@blogger.comtag:blogger.com,1999:blog-3537002903624765538.post-20472579237287763632012-02-12T17:07:01.824+00:002012-02-12T17:07:01.824+00:00Dear Mr Hemadri
I always read your mail fully and ...Dear Mr Hemadri<br />I always read your mail fully and try to understand as much as I can I never responded to your mail.<br />Your mail and blog is informative as well as thought provoking force brain to think.<br />Regarding this blog and reading complication and result of complication, yes it affected the young person life and his family. <br />Yes from surgeon point of view you can say this is one of complication. Even minor complication of any surgery always affect the surgeon as well if any anastomosis leak it affect for many days and future surgery as well. At least fearful for next few anastomoses. But no body think from that point of view. Prior to surgery I think no body can predict which type of complication is going to happen in this patient. <br />Like in WHO list prior to surgery one question 'do you have any concern to this patient' I am sure most of people will answer no concern but how cum this answer is right yes every body has concern to this patient.<br /><br />At the end only thing we can say its professional hazards we have to live with it can be minimized but difficult to eliminate, there should not be blame game.<br />Big question can we reach to perfection and predict regarding complication and date of discharge of patient.<br />Thanks VikasVikas Kumarhttps://www.blogger.com/profile/06018715639657818817noreply@blogger.comtag:blogger.com,1999:blog-3537002903624765538.post-17791954247159955222012-02-05T12:58:28.556+00:002012-02-05T12:58:28.556+00:00Dear Hemadri, You once again write with lot of pas...Dear Hemadri, You once again write with lot of passion and depth of thought. Complications are the bane of the surgeons. What you write is beyond the realms of the day-to-day surgeon. Typically complications can be divided broadly into Expected, Possible and Rare categories. Expected complications are usually unavoidable and occurs routinely as the scar, problems associated with the removal of a part, bleeding etc. This is definitely discussed and patient's understanding clarified. Possible complications usually are the ones that have occurred in the past but not routinely. This is also discussed before consenting. The Rare complications are those described in books and can happen if the case is complicated by previous surgeries or due to unexpected encounters like a lump very close to a nerve. This is also discussed. But it is not possible to speculate complications and their impact on personal life in any and every case. There will be never an end to such a discussion. Often services like counselling, visits to rehabilitation centres, discussion with other patients with similar procedures help to complete the picture and are suggested. Perhaps as a holistic approach this should be expanded and incorporated in every case but this causes a tremendous burden on the system and often leaves the patient and their relatives more confused. The end result is that they visit their GP to transfer their burden creating problems for the GP. We must take care not to appear to be too patronising, speculative and indecisive in what we do as a surgeon. There is an adage which is written in a lighter vein. If the surgeon is not keen on operating, tell the patient all the possible complications and more and the patient is sure to be frightened out of the idea of surgery. This, I am sure you will agree, will not be an acceptable approach.chanduhttps://www.blogger.com/profile/01584765710025548976noreply@blogger.com