Session Objective: Describe methods for assessing perfusion practice. Compare and contrast current perfusion related guidelines to current perfusion practices.
Objective: Demonstrate how electronically acquired data may be used to identify variation that occurs during CPB and how this information may be used to inform the cardiac surgery team about the performance of their system and how it may further be used to measure the effects of process improvement efforts.
Continuous Quality Improvement (CQI) is a systematic method of assessing the performance of a team or system1. Dickinson and colleagues found that top performing hospitals had higher compliance with quality indicators than hospitals that did not have high performance ratings2. Newland and colleagues have demonstrated the value of using electronically acquired data as a source of quality indicators during CPB3. Electronically acquired data offers several advantages to manually recorded data including; the ability to perform frequent measurement (20 second intervals), elimination of recorder bias, and the capacity to record more parameters simultaneously. Quality indicators may be selected from electronically acquired continuous variables (for example; arterial blood pressure, arterial blood temperature, and venous blood saturation). These electronically acquired data may be used to detect and quantify variation that occurs during CPB. This information can be used to compare individual and group performance. Furthermore they provide a means of quantifying the effect of changes in process that are implemented to improve quality. Acquired information may also be used immediate following CPB to initiate dialog about variation that occurred during the procedure, enhancing iterative learning. Examples of CPB quarterly quality reports and individual procedure reports will be presented.
Summary: Electronically acquired data may be used to generate information for teams that exceeds what is possible with manually recorded information. The highly detailed data may be transformed into information about the performance of the team or system on a single case or multiple cases over time. This information can be used to evaluate and improve performance.
Mechanisms for Assessing: Electronic vs. Paper DatabasesReferences1. Svenmarker S, Haggmark S, Jansson E, Lindholm R, Appelblad M, Aberg T. Quality assurance in clinical perfusion. Eur J Cardiothorac Surg. 1998 Oct;14(4):409-14.2. Dickinson T, Riley J, Zabetakis PM. External validation of compliance to perfusion quality indicators. Perfusion. 2004;19(5):295-9. 3. Newland RF, Baker RA, and Stanley R Electronic Data Processing:The pathway to automated quality control of CPB. JECT 2006;38:139-43. |
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