Organisational failures in urgent and emergency surgery. A potential peri-operative risk factor

Anaesthesia. 2001 Jul;56(7):684-9. doi: 10.1046/j.1365-2044.2001.01374-4.x.


Medical error is an important cause of morbidity and mortality. Organisational failure in the pre-operative period has been associated with catastrophic outcome. Little information is available regarding peri-operative organisational problems. The incidence and nature of organisational failure before urgent and emergency surgery in a district general hospital was studied prospectively in 159 cases over a 30-day period. Organisational failure affected more than half of the cases overall, but varied in both its incidence and its complexity between surgical disciplines. Various causative factors were identified, e.g. 8% of cases were subject to delay due to clinical emergencies. The median [range] time required to rectify the problems was 115 [5-750] min. A consultant anaesthetist and surgeon were present in 30 and 20% of cases, respectively. Difficulty with the preparation of patients for emergency surgery is an important but underevaluated cause of medical error that may put patients at risk.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Emergencies
  • Emergency Medicine / organization & administration
  • Female
  • General Surgery / organization & administration*
  • Hospitals, District / organization & administration
  • Hospitals, District / standards
  • Hospitals, General / organization & administration
  • Hospitals, General / standards
  • Humans
  • London
  • Male
  • Medical Errors / statistics & numerical data*
  • Medicine / statistics & numerical data
  • Middle Aged
  • Preoperative Care / standards*
  • Prospective Studies
  • Risk Factors
  • Specialization