Neurosurgery clinics of North America
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Medical errors are common and dangerous, estimated to cause over 400,000 deaths per year in the United States alone. The field of neurosurgery is not immune to these errors, and many studies have begun analyzing the frequency and types of errors that neurosurgical patients experience, along with their effects and causes. Fortunately, these data are guiding new innovations to reduce and prevent errors, like checklists, computerized order entry, and an increased appreciation for volume-outcome relationships. This article describes the epidemiology of errors, their classification, methods for identifying and discovering errors, and new strategies for error prevention.
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Neurosurgeons and hospitalists are turning to comanagement arrangements to address medical problems in surgical patients. Compared with traditional medical consultation, comanagement lets the hospitalist share authority and responsibility for patient care. It is associated with improved provider satisfaction and more efficient care, but impact on clinical outcomes is uncertain. Shared responsibility for patient care requires careful planning to avoid conflicts and fragmentation of care.