Molina G, et al. - This research was designed to assess whether the perception of safety of surgical practice among operating room (OR) personnel was associated with hospital-level 30-day postoperative death. Researchers confirmed an association of perception of OR safety of surgical practice with hospital-level 30-day postoperative death rates.

Methods

• As part of the Safe Surgery 2015: South Carolina initiative, a baseline survey measuring the perception of safety of surgical practice among OR personnel was completed.
• Researchers determined the association between hospital-level mean item survey scores and rates of all-cause 30-day postoperative death using binomial regression.
• Using supervised principal components regression, they controlled models for multiple patient, hospital, and procedure covariates.

Results

• Among 31 hospitals, researchers observed an overall survey response rate of 38.1% (1793/4707).
• For every 1 point increase in the hospital-level mean score for respect [adjusted relative risk (aRR) 0.78, 95% CI 0.65–0.93, P = 0.0059], clinical leadership (aRR 0.86, 95% CI 0.74–0.9932, P = 0.0401), and assertiveness (aRR 0.71, 95% CI 0.54–0.93, P = 0.01) among all survey respondents, they observed associated decreases in the hospital-level 30-day postoperative mortality rate after inpatient surgery ranging from 14% to 29%.
• In this study, higher hospital-level mean scores for the statement, “I would feel safe being treated here as a patient,” were associated with significantly lower hospital-level 30-day postoperative death rates (aRR 0.83, 95% CI 0.70–0.97, P = 0.02).
• Although most findings seen among all OR personnel were seen among nurses, they were frequently not observed among surgeons.