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Changing our culture to advance patient safety

The 2013 AANS Presidential Address

Mitchel S. Berger, Robert M. Wachter, S. Ryan Greysen and Catherine Y. Lau

codes for these “never events,” recorded only 9 such events over a 3-year period. The ABNS Credentials Committee identified 41 wrong-site or wrong-side surgeries in a 10-year period. The Joint Commission reported nearly 900 wrong-patient/wrong-site/wrong-procedure events throughout surgery in general over an 8-year period. If we break out just neurosurgery, there were 27 “never events” in this 8-year period. So this averages out to be about 2–4 events per year. But there was an article that came out of a Canadian survey in which 25% of polled neurosurgeons reported

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Catherine Y. Lau, S. Ryan Greysen, Rita I. Mistry, Seunggu J. Han, Praveen V. Mummaneni and Mitchel S. Berger

the checklist. Although no wrong-site or wrong-side surgeries were reported in their study, a recent national survey of neurosurgeons reveals an otherwise troubling trend. Twenty-five percent of surveyed neurosurgeons reported making an incision on the wrong side of the head, and 35% reported wrong-level lumbar surgical procedures during their career. 11 In addition, the operative checklist that was implemented in the Mayo Clinic study did not address any concerns specific to neurological surgery and did not explicitly encourage open communication practices among