Erbel R, Sommerfeld U, Ashry M, Haude M
Abteilung Kardiologie Medizinische Klinik und Poliklinik Universität-GHS Essen.
Z Kardiol. 1994;83 Suppl 6:43-55.
Quality management within the catheterization laboratory includes the quality control, the heart catheterization technique and the policy. Quality management is critical in the heart catheterization laboratory. Dedication of all members of the lab and computer personnel ensures high patient satisfaction. A continued quality improvement program is patient-orientated and requires good planning. One of the main emphasis in the catheterization lab is standardization which includes the patient preparation, the procedure itself, and the management. It is supported by teamwork including the economic aspect of prompt delivery of material and avoidance of complications. A continuous circle of treatment planes, performance, and check is regarded as the Deming cycle and leads to continuous improvement of quality. Important are both the avoidance and detection of complications. The reasons for any such have to be evaluated. It is recommended to follow the zero mistake hypothesis of Crosby, which means quality control by the lab supervisor, a quality consciousness, a quality measurement and quality improvement, as well as using a day to day quality improvement and to teach quality control. In Germany a quality control questionnaire was administered in an analysis of the current structure, function, and results of catheterization labs. Most important was the analysis of complications. The data were based on diagnostic catheterization in 1992, which included 140668 catheterizations in 83 laboratories. Thus, a mean of 1030 heart catheterizations was performed in each lab. In the mean, 200 catheterizations were performed by each doctor. In 19% of the labs digital imaging was exclusively performed. Major complications occurred with ventricular fibrillation in 0.36% (range 0.75%), resuscitation 0.18% (0.43%), persistent cerebrovascular accident 0.08% (0.24%), myocardial infarcts 0.19% (0.59%), aortic dissection 0.05% (0.22%). Mortality was 0.03% (0.08%). In heart catheterization laboratories quality management is one of the major goals for the future work. Only the continued improvement of quality and very good quality management ensure patient safety. Quality is the sum of technique and consciousness.
心导管室的质量管理包括质量控制、心脏导管插入技术和政策。质量管理在心导管室至关重要。实验室所有成员和计算机人员的奉献确保了患者的高度满意度。持续质量改进计划以患者为导向，需要良好的规划。心导管室的主要重点之一是标准化，包括患者准备、操作本身和管理。这得到团队合作的支持，包括及时交付材料的经济方面以及避免并发症。治疗方案、性能和检查的持续循环被视为戴明循环，并导致质量的持续改进。避免和检测并发症都很重要。必须评估任何此类情况的原因。建议遵循克罗斯比的零错误假设，这意味着由实验室主管进行质量控制、质量意识、质量测量和质量改进，以及采用日常质量改进并教授质量控制。在德国，通过一份质量控制调查问卷对心导管室的当前结构、功能和结果进行了分析。最重要的是对并发症的分析。数据基于1992年的诊断性心导管插入术，其中包括83个实验室的140668例心导管插入术。因此，每个实验室平均进行1030例心脏导管插入术。平均而言，每位医生进行200例导管插入术。19%的实验室仅进行数字成像。主要并发症包括心室颤动发生率为0.36%（范围0.75%）、复苏为0.18%（0.43%）、持续性脑血管意外为0.08%（0.24%）、心肌梗死为0.19%（0.59%）、主动脉夹层为0.05%（0.22%）。死亡率为0.03%（0.08%）。在心导管室，质量管理是未来工作的主要目标之一。只有持续提高质量和非常良好的质量管理才能确保患者安全。质量是技术和意识的总和。
