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[Systematic internal quality control in surgery 1993 to 1997].

T Junginger1, R Küchle, P Dutkowski

  • 1Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg Universität.

Zeitschrift Fur Arztliche Fortbildung Und Qualitatssicherung
|February 24, 1999
PubMed
Summary

Systematic internal quality control in surgery demonstrated consistent patient outcomes despite an increasing number of older, sicker patients. This quality improvement program identified surgeon experience as a key factor in complex procedures, enhancing patient care.

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Area of Science:

  • Surgical Quality Improvement
  • Healthcare Management
  • Patient Outcomes Research

Context:

  • Prospective data collection from 5690 patients between April 1993 and December 1997.
  • Implementation of a systematic internal quality control program.
  • Increasing proportion of elderly and comorbid patients undergoing surgery.

Purpose:

  • To assess treatment quality and drive quality improvement in surgical patient care.
  • To evaluate the impact of systematic quality control on postoperative morbidity and lethality.
  • To identify risk factors influencing surgical outcomes, such as surgeon experience.

Summary:

  • Despite a rise in complex cases, morbidity and hospital lethality remained stable.
  • University hospitals showed lower complication rates and comparable or reduced lengths of stay for specific procedures.

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  • Improvements noted in appendectomy rates, esophageal carcinoma treatment, and rectal carcinoma surgery outcomes (continence preservation).

    • Impact:

    • Systematic quality control effectively assesses treatment quality and identifies areas for improvement.
    • Surgeon experience was a significant factor in partial duodenopancreatectomy outcomes.
    • The program serves as a valuable tool for quality management in surgical patient care, with plans for future inclusion of long-term results and quality of life data.