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October 7, 2020

Rescuing Failure to Rescue—Patient Safety Indicator 04 on the Brink of Obsolescence

Author Affiliations
  • 1Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Division of General Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland
  • 4Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Surg. Published online October 7, 2020. doi:10.1001/jamasurg.2020.2971

Measuring outcomes is a critical step toward improving quality of patient care. For example, inpatient deaths following elective surgery are rare, but measuring them is an important first step to find ways to prevent them. One could further argue that, in a well-designed and well-run system, these deaths should never happen. Elective surgery should be offered selectively, and postoperative care should be adequate to rescue patients having minor complications from progressing to major events such as death. If measurement is an important component of quality improvement and deaths from elective surgery are a highly undesirable event, pairing these consensus-held beliefs is both sensical and meaningful for optimizing patient care.

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