{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T16:03:23Z","timestamp":1780675403157,"version":"3.54.1"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Failure to rescue (FTR)\u2014death following a potentially manageable complication\u2014has become a key quality indicator. Although clinical and systemic contributors to FTR are well described, how surgeons make sense of these events and how this sense-making shapes communication, escalation, and learning remains underexplored.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To explore surgeon interpretations of FTR events and perceptions of factors that contribute to FTR and to identify insights to inform improvements in surgical education and culture.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Qualitative study using convenience sampling to recruit board-certified surgeons with 5 or more years of experience in Switzerland and Austria via email. Semistructured interviews were conducted between February and May 2023. Data analysis was performed between February 2024 and April 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Direct involvement in FTR events.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Interviews were analyzed using a constructivist grounded theory approach to identify themes characterizing surgeons\u2019 perceptions of FTR.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Fourteen surgeons were interviewed, including 12 men (85.7%) aged 33 to 67 years (mean [SD] age, 49 [9] years). Specialties included abdominal surgery (9 surgeons [64.3%]), orthopedics or traumatology (4 surgeons [29%]), and vascular surgery (1 surgeon [7.1%]). Five themes were developed: (1) being trapped in a flawed system: surgeons perceived FTR as inevitable within systemic and institutional constraints; (2) hierarchical barriers: the continued predominance of barriers hinder adequate reaction and shared decision-making; (3) being imperfect heroes: surgeons saw themselves as passionate, resilient, and driven, yet vulnerable to narcissism, peer hostility, and performative behaviors; (4) coping with failure: participants reflected that FTR experiences, though painful, contributed to improving their clinical expertise; and (5) strategies and tools for rescue: these were characterized by sharing personal strategies and proposing system-level improvements.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this qualitative study of 14 surgeons, participants described how confidence, grit, and self-reliance were essential in surgery but could also hinder timely recognition and response to complications. Fostering humility, reducing hierarchical barriers, and increasing peer support may transform FTR from a heroic surgeon\u2019s hubris into an opportunity for collective learning and cultural growth.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.17064","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T15:30:24Z","timestamp":1780673424000},"page":"e2617064","source":"Crossref","is-referenced-by-count":0,"title":["Surgeon Perceptions of Failure to Rescue After Surgery"],"prefix":"10.1001","volume":"9","author":[{"given":"H\u00e9l\u00e8ne L.","family":"Gros","sequence":"first","affiliation":[{"name":"Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St Claraspital and University Hospital Basel, Basel, Switzerland"},{"name":"University of California, San Diego, La Jolla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Werdecker","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University Hospital Basel, Basel, Switzerland"},{"name":"Klinikum Kassel, Gesundheit Nordhessen, Department of Plastic, Aesthetic and Hand Surgery, Kassel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavishani","family":"Gunatharan","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St Claraspital and University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Gockel","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St Claraspital and University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beat P.","family":"M\u00fcller-Stich","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St Claraspital and University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Klasen","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St Claraspital and University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"issue":"4","key":"zoi260479r1","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1001\/jamasurg.2013.4064","article-title":"The relationship between timing of surgical complications and hospital readmission.","volume":"149","author":"Morris","year":"2014","journal-title":"JAMA Surg"},{"issue":"7","key":"zoi260479r2","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1097\/00005650-199207000-00004","article-title":"Hospital and patient characteristics associated with death after surgery. 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