Minimising risk in gynaecological surgery

Abstract

Gynaecological surgery involves risks, predominantly to the woman, though potentially to the staff. This article considers how risks in gynaecological surgery can be avoided or reduced as well as how to learn lessons from adverse events. To do this, the background to risks in healthcare and the theory of reducing error by taking an organisational rather than individual approach to identification and prevention will be discussed. No individual is perfect and punishment does not reduce error. This approach demonstrates that reducing risk requires a combination of prospective and reactive measures.

Having established the basic principles, we consider the approach to gynaecological surgery that minimises risk by ensuring adequate assessment, explanation of risk and that the surgeon and the surgical team are appropriately trained to undertake the task and deal appropriately with problems that arise. The reactive element of reducing risk is to acknowledge adverse outcome as it occurs and to have in place a system to report with a trigger list of events relevant to gynaecological surgery. Then, the root causes which are generally organisational rather than individual are identified to improve practice by learning from the analysis.