Introduction: Redefining Surgical Quality Through Failure to Rescue
For decades, the quality of surgical care was primarily measured by postoperative complication rates. However, recent shifts in healthcare quality research suggest that complications may be less a reflection of hospital quality and more a reflection of patient baseline health and the complexity of the procedure itself. Instead, the metric of Failure to Rescue (FTR)—defined as the probability of death following a treatable postoperative complication—has emerged as a superior indicator of institutional performance.
FTR focuses on the hospital’s capacity to detect, escalate, and manage complications once they occur. While complication rates represent the ‘occurrence’ of a problem, FTR represents the ‘response’ to that problem. A new study published in JAMA Network Open by Schwappach et al. provides a critical examination of FTR within the Swiss healthcare system, uncovering significant systematic variations that suggest over 1,000 deaths over a five-year period could have been avoided through better institutional rescue processes.
