"Do no harm"--ORReady initiative aims to improve safety and outcome for 6 million patients.

In 1999, the Institute of Medicine (IOM) published a landmark report, To Err is Human: Building a Safer Health System.[1] The IOM reported that up to 98,000 Americans die each year due to medical error and that more people were dying from medical errors than from motor vehicle accidents, breast cancer, or AIDS. The report defined safety as “freedom from accidental injury” and brought patient safety issues into the spotlight. While some complications are unavoidable, others are preventable errors. All possible measures should be taken to mitigate these errors and encourage safety in the operating room and all aspects of medical care. The IOM report was a “call to action to make health care safer for patients.”

Twelve years later, much has been achieved, but patient safety still remains an important issue. Most of the IOM's recommendations have not been achieved, and patient safety is still not considered a public health issue.[2] Much is yet to be accomplished and prevention is key. ORReady is a new world multispecialty initiative to encourage steps that are known to increase patient safety in the operating room, and in turn to improve surgical outcomes and save lives. The goal of ORReady is to share ideas to prevent errors and to promote safety among the surgical community.

It is estimated that over 230 million operations are performed each year.[3] Due to the complicated nature of many surgical procedures, there is opportunity for error if important steps are not taken to aid in their prevention. It is not necessary to convince athletes that it is important to warm up to prevent injury, to convince pilots to use checklists, or to convince important thinkers to take a time-out to solve a problem. Yet, in the operating room, these steps are not universally used. Research and studies in various industries show that applying safety steps like warm ups, checklists, and time-outs in the operating room can decrease complication rates and improve outcomes for patients.[4-6] Top surgeons, nurses, and teams in hospitals and operating rooms around the world in multiple specialties have adopted various forms of these steps, reducing error rates by up to 40% and even cutting death rates in half. ORReady's goal is to disseminate the most up to date information on surgical patient safety and protocols. It will make proven protocols available at the click of the mouse to researchers and OR teams interested in adding safety protocols to their operating routine and improving outcomes for their patients.

The mission of ORReady is to encourage the adoption of these protocols that will be beneficial to hospitals and OR teams and to have all hospitals utilize some type of protocol in the next 6 years. A goal of ORReady is to improve surgical outcomes for 2% to 3% of surgical patients each year by having surgeons and hospitals commit to patient safety protocols in their respective institutions. While this is a conservative estimate, just this small percentage when extrapolated globally means that we can improve outcomes for roughly 6 million patients worldwide by taking simple, proven steps.

The IOM's To Err is Human report recommended that, “Performance standards and expectations for healthcare professionals should focus greater attention on patient safety.” It encouraged professional organizations to make a commitment to patient safety, to aid in disseminating information, and to collaborate with other professional societies to continue to promote patient safety.[1] These are all achievable through, and components of, the ORReady program. Individuals who are interested in becoming more involved can become ORReady Advisors and represent their own institutions. These advisors are leaders of Surgical, Nursing, Medical, MIS Societies, and Health Organizations from multiple countries who share the idea that by working together with the power of the Internet and research we can accomplish great things.

At an institutional level, hospitals or departments can register as CentersOfMerit to encourage OR safety and better outcomes. ORReady follows the Creative Commons guidelines and encourages others to use any materials that will help improve surgical outcome and create CentersOfMerit in Surgery. Hospitals and practices that want to get involved can visit www.ORReady.org and download an Outcome Commitment Letter for a hospital CEO or Department Chair to sign and keep on file. This will be a sign of a hospital or department's commitment to patient safety and towards helping reach the goal to improve outcomes in their own community and worldwide. Hospitals are encouraged to choose those safety protocols whose merits suit their hospital and to implement them throughout their institution.

Another goal of ORReady is to work with researchers to create a database where outcomes can be recorded and evaluated. Data will be shared and Open-Access will be provided to research with the goal of understanding and improving surgical outcomes.

This year, the Society of Laparoendoscopic Surgeons was awarded the ACME Medical Specialty Society Great Idea Award for ORReady. The award recognizes a best practice or innovative contribution that promotes sharing and/or collegiality. This initiative has great potential to have an impact on a worldwide scale by applying simple steps. Through ORReady, there is an opportunity to improve outcomes for 6 million patients each year. This grassroots effort will continue to gain momentum and improve outcomes for patients as more individuals and institutions join the effort to make patient safety a priority. ORReady is a new call to action for surgical providers and anyone who wants to ensure freedom from accidental injury during surgery and improved outcomes for patients worldwide. Those interested in this important effort can find more information at www.ORReady.org.