Why urologists should discuss adverse events with each other


"We must do more to help surgeons prepare for the impact of adverse events before they happen," says Kevin Turner MA DM FRCS(Urol).

In this video, Kevin Turner MA DM FRCS(Urol), shares next steps and the take-home message of the recent Urologic Oncology paper “Hospital and departmental level strategies for managing the impact of adverse events on surgeons.” Turner is a consultant urological surgeon and visiting professor of urology at Royal Bournemouth Hospital and Bournemouth University, the United Kingdom.


What are some next steps following this paper?

I think that it's now beyond any doubt that when things go wrong in the surgical care of patients, surgeons are affected. And I should say, and I try to always say this, that one recognizes immediately that the person or people most affected are the patient and the people that love that patient. I hope that goes without saying, but surgeons are affected, and that has an impact on surgeons' physical and psychological health, and on their professional performance. For example, surgeons who are impacted by an adverse event are more likely to make an error, which of course leads to another adverse event. Two logical conclusions must follow from that observation. Firstly, we must do more to help surgeons prepare for the impact of adverse events before they happen. This is, after all, an inevitable consequence of surgical life. We know about it, and we prepare surgeons for other things that happen in surgical practice. So we should prepare surgeons for this. And the second thing that must follow and is only logical is that we must support surgeons better after adverse events. Now although those 2 conclusions are obvious, how you work those things out practically is not so obvious. It's important that we do some more work in how surgeons can be prepared before things go wrong, and that work centers around resilience and psychological flexibility. It's also very important we do some more work in terms of developing, designing, sustaining, and evaluating resources that are put in place in all hospitals where surgeons are employed to help surgeons deal better with those adverse events after they happen.

What is the take-home message for the practicing urologist?

I think to recognize that being impacted by adverse events is ubiquitous; it is an inevitable consequence of surgical practice. And if this happens to a urologist, then they are not alone, even though we're not very good at talking about this. If we do nothing else, we must talk to each other about this more, and our own work shows that just talking about it in a way which is not particularly difficult, but just talking about it helps to mitigate that adverse event. Beyond that, the take-home message for all urologists, I hope, is because urology is a specialty characterized by collaboration and innovation, which is what draws us to urology, is I hope urologists will be right at the forefront of developing both resources that help surgeons prepare for adverse events and help surgeons support each other better after adverse events.

This transcription was edited for clarity.

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