Failure to Rescue, Rescue Surgery and Centralization of Postoperative Complications: A Challenge for General and Acute Care Surgeons

Chirurgia (Bucur). 2017 Sept-Oct;112(5):538-545. doi: 10.21614/chirurgia.112.5.538.

Abstract

Purpose of review: To explore the current literature on the failure to rescue and rescue surgery concepts, to identify the key items for decreasing the failure to rescue rate and improve outcome, to verify if there is a rationale for centralization of patients suffering postoperative complications.

Recent findings: There is a growing awareness about the need to assess and measure the failure to rescue rate, on institutional, regional and national basis. Many factors affect failure to rescue, and all should be individually analyzed and considered. Rescue surgery is one of these factors. Rescue surgery assumes an acute care surgery background.

Summary: Measurement of failure to rescue rate should become a standard for quality improvement programs. Implementation of all clinical and organizational items involved is the key for better outcomes. Preparedness for rescue surgery is a main pillar in this process. Centralization of management, audit, and communication are important as much as patient centralization.

Keywords: acutecaresurgery; centralization; frailty; postoperativecomplications; rescuesurgery; traumacomplications.

Publication types

  • Review

MeSH terms

  • Decision Support Techniques
  • Delivery of Health Care*
  • Evidence-Based Medicine
  • Failure to Rescue, Health Care*
  • General Surgery*
  • Health Status Indicators
  • Hospital Mortality*
  • Humans
  • Postoperative Complications / mortality
  • Postoperative Complications / therapy*
  • Quality Improvement
  • Registries
  • Risk Assessment
  • Risk Factors
  • Treatment Failure
  • Treatment Outcome