To explore factors influencing failure-to-rescue (FTR) events, defined as death following a potentially manageable complication, as described by surgeons.
Key Findings:
Five themes identified: flawed systems, hierarchical barriers, imperfect heroes, coping through failure, and strategies for rescue.
System-level barriers included fragmented care, administrative demands, fatigue, communication failures, and economic pressures.
Hierarchical barriers led to reluctance in escalating concerns among junior physicians.
Surgeons reported emotional consequences like guilt and shame following FTR events, often leading to avoidant coping strategies.
Adverse events were viewed as learning experiences that could influence future practice.
Interpretation:
Surgeons perceive FTR as influenced by both organizational conditions and professional culture.
Limitations:
Small sample size of 14 volunteer surgeons may not represent broader perspectives, potentially favoring those more willing to discuss adverse events.
Study predominantly included male participants and those practicing in Switzerland.
Lack of hospital-level FTR rates limited assessment of institutional influence.
Qualitative design does not establish causal relationships or frequency of identified factors.
Conclusion:
Surgeons recognize the interplay of organizational and cultural factors in FTR events, highlighting the need for systemic changes.
