Development and application of a quality assurance information system in cardiac surgery (QUADRA study)

Preventive measures for quality in cadiac surgery which are based on electronic data processing initially have to overcome a variety of obstacles. Some of the most serious encountered are the need for more extensive but more precise and correct documentation, the definition of quality and the identification of parameters to assess it, fears that means to check everything and everybody are being installed, and finding ways to found the measures. The measures have two aims at least: ensuring a broad general standard of treatment which every patient can expect, and supporting efforts at a continuous improvement of treatment methods and thus of the results. These aims dictate that any measures instituted have to be of a permanent nature: they cannot be reached in the long term by a simple supplementary activity such as a research project. On the contrary, a complete integration in the general hospital routine and in the standard documentation and information processes is necessary. As these today still are not usually based on clinical progress reports which are formally suitable for data processing, reorganisation to achieve this is a prerequisite for successful quality assurance. This means, however, that those responsible for quality must help in the reorganisation.