[Is heart surgery in the Netherlands sufficiently safe?]

Recently the media, including this journal, paid attention to some cases of true or alleged failure of open heart surgery, i.e. mortality due to heart valve replacement, poor outcome in paediatric heart surgery (the so-called Bristol affair), and a series of failed Björk-Shiley mechanical heart valves, thereby questioning the safety of heart surgery. Viewed from a safety perspective, there is a need for criteria for safety assessment of health care services, initiatives aiming at staff exchange and transparency of performance data, and the role of safety committees and safety management plans. Medicolegal developments illustrate the increasing relevance of risk information for patients based on physician experience and hospital performance with respect to maintaining safety standards.