ANALYSIS OF ADVERSE OUTCOMES AS AN ELEMENT OF IMPROVING THE RESULTS OF EMERGENCY SURGICAL CARE

Objective: to improve the system of increasing the quality and safety of surgical care by analyzing adverse outcomes and introducing interdisciplinary educational technologies in the training of surgeons. Material and methods. The authors examined 625 medical records of patients who died in surgical hospitals for compliance of the emergency surgical care with current regulatory requirements. The authors developed and implemented an educational method of additional training of surgical specialists based on gamified forensic medical analyses of criminal "medical" cases from open judicial practice. At the first stage of the game, the task of the students is to immerse themselves in a simulated criminal process, collect details of the incident, analyze the care provided to the patient, possible diagnostic and treatment defects, and also justify, based on the realities of domestic healthcare, the correctness (incorrectness) of the surgical care. At the second stage, an open discussion takes place with the participation of various specialists in a specific criminal case: practicing surgeons, forensic experts, employees of specialized departments, experts from the Ministry of Health and the territorial fund for medical insurance, lawyers. The authors illustrated a similar interdisciplinary analysis of a clinical case of providing emergency surgical care to a victim with penetrating stab wounds to the abdominal cavity. Conclusions. Over the period from 2018 to 2022, there was a decrease in the number of preventable, conditionally preventable deaths and defects in the provision of emergency surgical care, which may be associated with a comprehensive study of adverse outcomes. According to authors’ opinion, the analysis of adverse outcomes can be used as one of the tools to improve the results of surgical care. The use of the innovative educational method of additional training of surgeons proposed by the authors can provide effective assistance in a set of measures to reduce mortality from manageable causes in the "Surgery" profile.