Illuminating the Black Box of Surgery

Main Article Content

Mitchell Goldenberg
Teodor P. Grantcharov



Surgeons know better than most the potential impact ones actions can have on a persons life. In the operating room, the difference between a successful and debilitating outcome is often not more than the result of a single wayward movement of the hand. Despite the high stakes, surgeons are permitted to carry on, for the length of their careers in many cases, without any recertification or even observation of their intraoperative performance. While all surgery will forever carry a certain risk of perioperative morbidity and mortality for reasons that are often out of the surgeons control, this should not quell our desire to constantly improve our outcomes for the benefit of our patients. Through analyzing and understanding the events and circumstances that lead to adverse patient outcomes, we can systematically target and improve deficiencies of skill and ability. This quality improvement (QI) mind-state is certainly not unique to medicine or surgery, and many of the initiatives described here draw their inspiration for non-medical sources.