Detecting Adverse Events in Dermatologic Surgery. DANIEL PINNEY. 2009; Dermatologic Surgery - Wiley InterScience

Detecting Adverse Events in Dermatologic Surgery
DANIEL PINNEY, BS * DANIEL J. PEARCE, MD * , AND STEVEN R. FELDMAN, MD, PHD *,†,‡
Departments of *Dermatology, †Pathology, and ‡Public Health Sciences, Center for Dermatology Research, School of Medicine, Wake Forest University, Winston-Salem, North Carolina

Address correspondence and reprint requests to: Daniel J. Pearce, MD, Department of Dermatology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, or e-mail: sfeldman@wfubmc.edu
Copyright © 2009 American Society of Dermatologic Surgery

ABSTRACT
BACKGROUND Despite increasing awareness of and public attention to patient safety, little is documented about how adverse events (AEs) can or should be monitored in dermatologic surgery. Data to address this shortcoming are needed, although well-defined methodologies have yet to be implemented.

OBJECTIVE
To summarize current strategies in detecting adverse outcomes of dermatologic surgical procedures.

MATERIALS AND METHODS
A Medline literature search was conducted using the terms "adverse event,""detection,""reporting,""monitoring," and "surgery." Articles selected addressed the efficacy of one or more AE reporting techniques in surgical patients.

RESULTS
Prospective and retrospective reporting methods were identified, with morbidity and mortality conference being the most commonly used method of AE reporting. Retrospective medical record review, the retrospective trigger tool approach, and an anonymous electronic reporting system were more sensitive approaches. The Surgical Quality Improvement Program, a program that has successfully translated AE data into lower postoperative morbidity and mortality, was analyzed.

CONCLUSIONS
Although generally considered safe, dermatologic surgery has no current standard for AE reporting. Standard definitions and high-quality data regarding AEs" currently limit this analysis. Pilot studies are needed to develop feasible measures, with the goal of increasing the sensitivity of AE detection and ultimately improving patient outcomes.

The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories.

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DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1524-4725.2009.01378.x About DOI

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Detecting Adverse Events in Dermatologic Surgery. DANIEL PINNEY. 2009; Dermatologic Surgery - Wiley InterScience