The North American Spine Society (NASS) is one of the sponsors of the annual BISS conference. Dr. Wong, as Past President of NASS, co-chaired this year’s 30th annual meeting. The theme for the conference was “Safety and Complications in Spine Surgery.”
Translating the aviation program of “Crew Resource Management” (CRM) into the operating room was a topic of discussion. The CRM system promotes teamwork and the ability of any member of the crew to initiate a “pause” in the workflow to address any concern involving safety. Dr. Wong, whose NASS Patient Safety Committee oversaw implementation of the “Highly Reliable Operating Room” project in the US, discussed this issue.
The reduction of medical errors in the operating room with the introduction of checklists was another topic. Dr. Wong, as one of the US members of the World Health Organization (WHO) Checklist workgroup which developed the original checklist, was involved in this discussion. The checklist includes: a pre-op team briefing, a time-out just prior to skin incision to review patient identification, equipment and imaging, plus a post-op briefing to discuss any issues impacting post-operative care.
The importance of the peer-reviewed spine literature publishing reports of complications from recently introduced technology was also discussed. The case series, co-authored by Drs. Wong, Jatana and Ghiselli, warning surgeons about the complication of unexpected and unwanted bone forming in the spinal canal with Bone Morphogenetic Protein (BMP) when used as a substitute for bone graft, was used as a prime example. While FDA approval ensures a degree of safety for new technology, once a product is in general use, it is not uncommon for additional complications to surface. The FDA’s post marketing surveillance program is often slow to accumulate “sufficient data” to notify physicians (and patients) about problems encountered post FDA approval.
Dr. Wong arrived in Brussels early so was able to join another Macnab fellow, Dr. John Dooley from London, for a tour of the Waterloo battlefield where Napoleon was defeated in 1815. The battlefield is a surprisingly small area, given that over 200,000 infantry and 60,000 cavalry fought in the one-day battle. They enjoyed the wonderful museums, including one at the farmhouse where Napoleon spent the night before the battle and planned the disposition of his army in the morning.
