The 10^th anniversary of patient safety in surgery

This year marks the 10^th anniversary of our open-access peer-reviewed journal “Patient Safety in Surgery” (PSS). In our launch editorial on November 7, 2007, we made a statement which appears to be still applicable a decade after the journal’s inception: “Despite the wide range of more than 200 official journals in the field of surgery, there is currently no single medical journal available which specializes on the issue of patient safety in surgery.” [1]. This notion reflects an apparent void in covering the pertinent topic of surgical patient safety in the scientific literature, and PSS seems to continuously represent a “niche” forefront pilot journal based on its exclusive focus dedicated to surgical patient safety. The journal’s international visibility has continuously grown in the past decade. Current statistics show a global readership of PSS in 185 countries with an average of 230,000 article accesses to the journal’s website each month (Fig. 1). This is an impressive increase compared to historical metrics of just 2000 monthly accesses at the time of the journal’s founding in 2007, and an average of 16,000 accesses per month at the 5-year anniversary mark in 2012 [2].

Fig. 1

Monthly number of articles accessed on the journal’s website (www.pssjournal.com) in 2017 (January–October). These metrics do not include article downloads from other databases, e.g. PubMed Central

In the past decade, the journal published a total of 325 open-access articles, all of which are cited in PubMed, SpringerLink (https://link.springer.com/journal/13037), and other indexing services that are listed on the journal’s website (www.pssjournal.com). The journal’s overall rejection rate is 20%. The prevalent countries of origin for articles submitted and published in 2017 are depicted in Fig. 2. The highest-ranking publication in the journal of all times is a review article from 2010 entitled “Complications in colorectal surgery: risk factors and preventive strategies” [3]. Until present, this particular paper alone has been accessed on the journal’s website more than 110,000 times, and was cited 80 times in other publications [3]. The top-10 most accessed and most cited articles in the journal are listed in Table 1 and Table 2, respectively.

Fig. 2

Countries of origin for submitted articles and publications in PSS (YTD 2017)

Table 1 Top-10 most accessed articles on the PSS website (as of Nov. 15, 2017)

Table 2 Top-10 most cited PSS articles in other publications (as of Nov. 15, 2017)

Another important aspect related to the journal’s global visibility is reflected by the so-called “Altmetric Attention Score”. This represents an emerging tool designed to assess the public attention that scholarly articles receive through the media, news outlets, blogs, and social media. The score is influenced by the quantity of posts that mention an article and by the quality of the source of posting. Of note, Altmetric measures public attention, not scientific quality. The PSS article with the highest Altmetric Attention Score of all times was a 2017 editorial entitled “Why do surgeons continue to perform unnecessary surgery?” [4]. Impressively, the article’s score of 414 falls into the top-5% of all research outputs scored by Altmetric [4]. These statistics reflect on an increased international visibility of the journal in the public media and other outlets. A list of the top-10 PSS articles ranked by Altmetric scores is depicted in Table 3.

Table 3 Top-10 Altmetric Attention Scores (as of Nov. 15, 2017)

In spite of these impressive metrics, which are reflective of a successful development and increased visibility of the journal since its inception in 2007, there is much work to be done. Notwithstanding significant developments in medical care and technology, the “modern age” of patient safety in the twenty-first century continues to fall short of protecting patients from unnecessary treatment, preventable harm, and death. Shockingly, current statistics have identified medical errors as the 3rd leading cause of death in the United States, secondary only to cardiovascular disease and cancer [5]. The hidden epidemic is subtantiated by evidence-based estimates of more than 400,000 preventable annual deaths occurring in United States hospitals every year [6], which does not take into account the innumerable preventable deaths subsequent to unsafe hospital discharges and medication errors in the outpatient setting. In spite of this egregious system failure, the medical profession continues to accept errors that lead to preventable patient harm as an unfortunate and inevitable “side effect” of modern health care. The unintentional void created by the absence of physician leadership in the field of patient safety has meanwhile been filled by other stakeholders, including patient advocacy groups, malpractice lawyers, and legislators. It is time for a change in mindset. A famous Chinese proverb fittingly states that “the best time to plant a tree was forty years ago; the second-best time is now.” Today is the time for the medical profession to make up for past negligence by taking the lead in driving patient safety as an irrefutable responsibility. The mission of this journal is to continue to provide an international forum for reporting, discussing, and mitigating errors and failures that lead to preventable patient harm and adverse outcomes. We would like to thank our readers, authors, and reviewers for their trust and loyalty over the past decade, and we hope to count on your continuing support of the journal’s mission.