Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting

Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting

Can J Surg 2020;63(1):E35-E37 | PDF | Appendix

Katie Garland, MD; Brian P. Chen, MD; Stephane Poitras, PhD; Eugene K. Wai, MD; Stephen P. Kingwell, MD; Darren M. Roffey, PhD; Paul E. Beaulé, MD

Summary

Ensuring adverse event (AE) recording is standardized and accurate is paramount for patient safety. In this discussion, we outline our comparison of AE data collected by orthopedic surgeons and independent clinical reviewers using the Spine Adverse Events Severity System (SAVES) and Orthopedic Surgical Adverse Events Severity System (OrthoSAVES) against AE data recorded by hospital administrative discharge abstract coders. In 164 spine, hip, knee and shoulder patients, reviewers recorded significantly more AEs than coders, and coders recorded significantly more AEs than surgeons. The AEs were recorded similarly by reviewers using SAVES and OrthoSAVES in 48 spine patients. Despite our small sample size and use of different AE tools, we believe it is important to highlight that coders, surgeons and reviewers recorded AEs differently. While further investigations on its utility and cost-effectiveness are necessary, we assert that it is feasible to use Ortho-SAVES to prospectively record AEs across all orthopedic subspecialties.


This work was presented at the Canadian Orthopaedic Association annual meeting held in Québec, Que., Canada, June 16–19, 2016

Accepted June 11, 2019

Affiliations: From the Faculty of Medicine, University of Ottawa, Ottawa, Ont., (Garland, Chen, Wai, Kingwell, Beaulé); the School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ont. (Poitras); the Division of Orthopaedic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Poitras, Wai, Kingwell, Beaulé); the uOttawa Combined Adult Spinal Surgery Program, The Ottawa Hospital, Ottawa, Ont. (Wai, Kingwell, Roffey, Beaulé); and the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont. (Wai, Kingwell, Roffey, Beaulé).

Competing interests: P. Beaulé declares receiving consulting fees from MicroPort, MatOrtho, Zimmer Biomet and Corin; royalties from MicroPort, Medacta and Corin; a grant from Zimmer Biomet; and research support from DePuy and Johnson & Johnson.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication. No other competing were declared.

DOI: 10.1503/cjs.019117

Correspondence to: P.E. Beaulé, CCW 1646, Division of Orthopaedic Surgery, University of Ottawa, The Ottawa Hospital, 501 Smyth Rd, Ottawa ON K1H 8L6, pbeaule@toh.ca