Pilot study on quality assurance in cardiac surgery.

In 1986 development, testing and improvement of a multi-center based quality assurance procedure has been started by the German Society for Thoracic and Cardiovascular Surgery supplied by a research fund of the Federal Ministry of Research and Technology. Initially five cardiac surgery units took part in defining quality related items, collecting associated data and establishing a common data base. In the first year of its existence this data base received about 3800 records of patients undergoing cardiac surgery procedures using ECC. Preoperative clinical state, intraoperative actions and postoperative results including unexpected events sum up to an average record length of 300 items per procedure. Evaluation and representation of quality related data ist done in two ways: an overall quality profile consisting of 17 so called quality indicators accompanied by six patient-mix indicators enables each cardiac surgeon to get a quick global reference within the multicentrical data context, and several problem oriented profiles assist building and testing of special quality-related hypotheses towards improvement of procedure standards and performance.