Patient safety in neurosurgery: Detection of errors, prevention of errors, and disclosure of errors

Error in medicine and surgery is a well recognized phenomenon. The Institute of Medicine's publication in 1999 included estimations that medical error is the eighth leading cause of death in the United States and results in up to 100,000 deaths annually. Large retrospective chart reviews and some prospective studies are adding to the information base regarding this challenging problem. Strategies to reduce error and increase patient safety are becoming well developed but have not traditionally been widely embraced by surgeons for a variety of reasons. The authors provide a review on patient safety aimed at surgeons (and specifically neurosurgeons), including definitions, incidence of error incorporating what is available in the surgical literature, causes of error, methods of error detection, strategies to minimize errors and maximize patient safety, and disclosure of error.