In exploring systems quality and surgical checklists, Neurosurgical Focus continues a proud tradition of neurosurgical exceptionalism. Tremendous advancements in the surgical treatment of neurological disease reflect lifetimes devoted to a sustained attention to detail and refinement of the craft of neurosurgery. This commitment affords our patients the favorable risk-benefit profile associated with once audacious procedures. The expansion and maturation of modern health systems, however, has brought new lessons and challenges. Practicing neurosurgeons now function in a larger, more complex health care delivery environment. Recognition of this evolving landscape prompted us to examine the best literature and lessons of systems-based quality improvement and to empower our readership as the foremost patient advocates.
The following issue represents the product of that effort. The presented papers divide into 4 major sections. The first section splits the care of the neurosurgical patient into preoperative, operative, and postoperative process improvement efforts. This section introduces tools ranging from surgical checklists to operative videos and formalized debriefing efforts. The second section expands on the literature supporting these process improvement efforts and provides data from institutions that validated these tools in the neurosurgical setting. The third section explores clinical issues and environments of particular interest to the broad practice of neurosurgery. And the final section provides subspecialty-specific considerations of process quality.
Taken together, these papers both empower our neurosurgical readership to apply the best lessons of management science and data with the same rigor and attention to detail devoted to their clinical practices, and firmly position neurosurgeons in their rightful position as the foremost patient advocates in their local institutions and in the national dialogue.
Disclosure
Dr. Khalessi is a consultant for Stryker Neurovascular and ev3, Inc./Covidien and receives non–study related research support from Penumbra and Microvention.
