Failure to rescue: A quality indicator for postoperative care

Postoperative complications occur despite optimal perioperative care and are an important driver of mortality after surgery. Failure to rescue, defined as death in a patient who has experienced serious complications, has emerged as a quality metric that pro-vides a mechanistic pathway to explain disparities in mortality rates among hospitals that have similar perioperative complication rates. The risk of failure to rescue is higher after invasive surgical procedures and varies according to the type of postoperative complication. Multiple patient factors have been associated with failure to rescue. However, failure to rescue is more strongly correlated with hospital factors. In addition, microsystem factors, such as institutional safety culture, teamwork, and other attitudes and behaviors may interact with the hospital resources to effec-tively prevent patient deterioration. Early recognition through bedside and remote monitoring is the first step toward prevention of failure to rescue followed by rapid response initiatives and timely escalation of care. (c) 2020 Elsevier Ltd. All rights reserved.

Automated summary

Postoperative complications can lead to mortality even with optimal perioperative care. Failure to rescue, where a patient dies after serious complications, has become a quality metric that explains mortality rate disparities among hospitals. The prevention of failure to rescue involves early recognition, rapid response, and timely escalation of care.