Quality assurance in hip arthroplasty

Documentation is key to quality assurance (QA): Data must be complete, plausible, and comparable, and then analyzed to implement corrective measures. Important factors are: qualification of care-providing staff, equipment and implants available (structural quality), effective scheduling of operations and therapy management (process quality), and patient status monitoring (outcome quality). The primary aim is to reveal deficits in process quality and develop and implement improvements in care. QA does not aim at exposing individual mistakes or flawed techniques; rather it is designed to analyze processes and treatments and implement specific solutions. An evaluation profile with the key quality indicators and a QA guideline is presented. A survey conducted in Germany, Austria, and Switzerland revealed: (1) up to 12-month waiting period for surgery in 6%, (2) only 40% written instructions, (3) data mostly written by hand, (4) differences in surgery planning and use of prosthesis passport, (6) inconsistent data analysis, (7) corrective measures rarely implemented.