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‘July effect’ does not apply to cardiac surgery
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The “July effect,” the perception that more medical errors occur in July compared with other months because that is when new medical school graduates start their in-hospital training, is not true in cardiac surgery, researchers reported.
“While the perception of the ‘July effect’ persists culturally among health care providers, we hope that this study reinforces the fact that hospital systems have in place processes that help provide the highest level of care and ensure patient safety,” Sameer A. Hirji, MD, MPH, clinical fellow in surgery at Brigham and Women’s Hospital, said in a press release. “Our findings are encouraging.”
The researchers analyzed CABG (n = 301,105), surgical aortic valve replacement (n = 111,260), mitral valve repair or replacement (n = 54,985) and isolated thoracic aortic aneurysm repair (n = 2,655) procedures included in the National Inpatient Sample between 2012 and 2014. They compared in-hospital mortality and complication rates by quarter and by month.
The researchers also found that teaching hospitals had lower rates of in-hospital mortality for surgical AVR and mitral valve surgery compared with nonteaching hospitals (P < .01 for both), but the same was not true for CABG or aneurysm repair.
The only significant difference in complications was that patients admitted for AVR in the first quarter were more likely to have postoperative cardiac complications compared with those admitted in the fourth quarter (14.7% vs. 13.5%; P = .02), Hirji and colleagues wrote.
“Cardiac surgery patients are managed in a multidisciplinary fashion; therefore, the well-being of patients is not solely dependent on one individual, but rather on the entire caregiving team and so may be more resistant to changes in hospital staff,” Rohan M. Shah, MD, MPH, cardiac surgery research associate at Brigham and Women’s Hospital, said in the release. “What this means for patients is that they should not be fearful or concerned about having surgery in July when the new residents are starting.” – by Erik Swain
Disclosure: One author reports he has financial ties with Abbott, Edwards Lifesciences and Medtronic.
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