Thorac Cardiovasc Surg 2017; 65(S 03): S209-S212
DOI: 10.1055/s-0037-1601047
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Georg Thieme Verlag KG Stuttgart · New York

Quality Control and Learning Curves at the Heart Center Leipzig

David M. Holzhey
1  Herzzentrum Leipzig, Herzchirurgie, Leipzig, Germany
,
Anne-Katrin Funkat
1  Herzzentrum Leipzig, Herzchirurgie, Leipzig, Germany
,
Jan Gummert
2  Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany
› Author Affiliations
Further Information

Publication History

24 February 2017

24 February 2017

Publication Date:
07 April 2017 (online)

For several years quality assurance has gained growing attention. De Leval was one of the first to outline the importance of analyzing human factors in cardiac surgery and of performing individual failure analyses.[1] [2] However, the usual means of descriptive statistics cannot be regarded sufficient in this field. The low numbers of particular operations per surgeon require additional analyses to detect changes in quality early. In this context, the usefulness of the sequential probability cumulative sum (CUSUM) technique to analyze surgical performance has been shown in recent publications.[3] [4] [5] [6] It allows detection of changes in perioperative mortality and morbidity already during the patient care process. It provides almost real-time monitoring of surgical performance if updated after each procedure. Also, CUSUM analysis acknowledges the importance of individual experience in monitoring performance and allows easy charting of a learning curve with regards to the incidence of perioperative complications. The charts are intuitively readable, but care is needed to avoid misinterpretation.[7] Moreover, the charts can also be used to depict learning curves and are therefore helpful in accompanying new surgeons during their initial training or experienced surgeons in the learning process of a new method.

In this article, we describe the developments in the field of quality control at the Leipzig Heart Center during the past two decades. The foundation for these initiatives was the creation and maintenance of a comprehensive institutional and national database.