Patient Safety Advocate Paul Alan Wetter

Paul Alan Wetter, MD, has been described as, “The single individual who has done the most to promote education and understanding of minimally invasive surgery worldwide”. A visionary, who has promoted technology and education that fosters less traumatic surgery, improves physician education, lowers costs, builds communities, accelerates discovery and learning, and lifts the level of surgical competence and patient outcome worldwide.

As one of the first surgeons to championadvanced laparoscopic surgery, Dr. Wetter brought together multiple surgicalspecialties to start a new type of medical multi-specialty society, the Societyof Laparoendoscopic Surgeons, which has become the largest of its kind in theworld with over 6,000 active members.

Dr. Wetter initiated an ambitious worldwideeffort, ORReady, to improve surgical outcomes for six million patients. Hespearheaded the publication of the first of their kind open-access, onlinemedical textbooks, which can be used at the bedside, in the office, library,and OR and have built-in language translation for worldwide utilization. He isthe co-founder of the Medical Journal, JSLS, which has had a monumental rise tothe top 100 journals of over 10,000 scientific publications online.

Dr. Wetter has received honors in manycountries for his sharing of ideas about MIS around the world, which influencedthe rapid rise of MIS. He formed the AsianAmerican and EuroAmerican MIS Summitswhere leaders from most countries and medical societies in these regionsattend. By developing these summits, he has put high-quality educational andresource materials into the hands of all surgeons and hospitals worldwide.

The driving source for his work is thelofty goal of giving every budding and experienced practitioner in the world anopportunity to contribute and learn. Dr. Wetter truly has mastered the art ofcollaboration and open access in medical education worldwide.

Dr. Wetter was nominated twice and theysaid the following: “Safety in any surgical procedure is the most importantfactor for ultimate patient benefit and the best outcomes. The Society ofLaparoendoscopic Surgeons has established steps in the ORReady criteria tomaximize safety and minimize potential complications. The motto has been “allabout the outcomes”. We have been implementing these criteria for many yearssince its inception and have seen clear benefits to the patients. Innovationand identification of ideas that promote better patient outcomes on a globalbasis. The ability to improve on a world basis is becoming easier. ORReady issupported by over 21 organizations on five continents and growing, and has ledto millions of better outcomes for patients.

ImprovingOutcomes for all Surgical Patients

Join ORReady, each of us can help.

Each year over two hundred and thirtymillion operations are performed. Experts estimate that by following a seriesof safety guidelines, a minimum of 2-3% (roughly six million surgical patientsaround the world) could have better surgical outcomes each year.

While this may help only a small number ofpatients in a small local hospital, cumulatively it has the potential of beingbeneficial to an enormous number of patients worldwide. Research has confirmedthat multiple industries benefit by applying the safety steps presented here.When applied in the surgical suite, these same steps can and do reducecomplication rates and improve outcomes for our patients. Top centers, leadingsurgeons, nurses and OR teams in multiple specialties have adopted variousforms of improvement and have been reducing error rates by 40% and cuttingdeath rates in half. Regrettably, many hospitals and surgeons worldwide havenot yet instituted these good-outcome-producing principles. The goal of ORReadyis to encourage worldwide use of the ORReady Steps in all hospitals and clinicsand surgical suites. These small steps improve the outcomes for 6,000,000patients worldwide annually.

This is the task of ORReady. Its goal isfor health care professionals to follow guidelines that would begin with theinclusion of Check Lists, Time Outs, and Warm-Ups routinely to ensure bettersurgical outcomes. ORReady is also assessing other ideas that work to improvepatient care. ORReady estimates that 6 million patients around the world wouldhave better outcomes if better guidelines were followed. Health Clinics,Surgical Suites and Hospitals are encouraged to participate by adding theirideas that work to improve patient safety.

It all starts with Check Lists, Time Outsand Warm-ups used as part of the surgical protocol and process to ensure betteroutcomes for all patients.

Over the past few years over 21organizations on five continents have joined with ORReady and are working tocontinually assess and improve outcomes for patients.

You can become part of this effort bysubmitting ideas that work from your facility which can be shared with others.These can be sent to Dr. Wetter at Paul@SLS.org. Also, if you have a specialinterest in improving surgical outcomes and wish to further participate,ORReady is looking for volunteers to help spread the word and good practices.

Join the ORReady Advisors Group: ORReadyAdvisers are leaders of surgical, nursing, medical, MIS Societies and healthorganizations from multiple countries who share the idea that by workingtogether with the power of the Internet and cooperative research we canaccomplish great things. Organizations who choose to participate are encouragedto appoint a leader to the ORReady Advisers Group.

The three main steps incorporated in theTraffic light logo encourage teams to 1. Slow down for Warm Up and Check lists;2. Stop for Time out; then 3. Go ahead with the procedure.

Teams are encouraged to keep improvingthese and other useful steps and when a significant improvement is documentedto share these with other ORReady teams around the globe through ORReady.

With rapid changes in technology andarrival of new techniques and procedures, ORReady can facilitate rapid openaccess sharing of data and receive feedback for new things that work to improvepatient care.

ORReady has been awarded with an Alliance for Continuing Medical Education Great Idea Certificate in the Medical Specialty Societies Member section.

References

1. Wetter PA, Rovira IK. "Do noharm"--ORReady initiative aims to improve safety and outcome for 6 millionpatients. JSLS. 2011;15(2):131-2.

2. WHO Check Listshttps://www.who.int/patientsafety/safesurgery/checklist/en/

3. Lendvay TS, Brand TC, White L, et al.Virtual reality robotic surgery warm-up improves task performance in a drylaboratory environment: a prospective randomized controlled study. J Am CollSurg. 2013;216(6):1181-92.

4. Allegranzi B, Conway L, Larson E, PittetD. Status of the implementation of the World Health Organization multimodalhand hygiene strategy in United States of America health care facilities. Am JInfect Control. 2014;42(3):224-30.

5. WHO Save Lives:Clean Your Hands https://www.who.int/gpsc/5may/en/

Originally published in  Issue 1, 2019 of MT Magazine.