[Systematic assessment of postoperative complications. A form of personal quality control].
A quality control program for the surveillance of surgical complications is described which includes all persons working at a surgical unit. The house surgeon when writing his letter for the general practitioner after the patient is demissed uses a special form for postoperative complications. Ten well defined types of complications, e.g. haematoma, fistula, abscess, pneumonia are recorded. Another surgeon responsible for the control program gathers weekly all forms presenting the results monthly at an audit to all surgeons of the unit. Here results are discussed in detail. Each surgeon gets his own complication profile monthly. Every three months the results of surveillance program are presented to all staff members including nurses, so that cooperative actions to reduce the complication rate can be taken. From January 1, 1985 to June 30, 1987, 2597 operations were performed, 213 patients (8.2%) suffered postoperative complications especially after surgery of the colon and rectum (28%), cholecystectomy (26%) and hernia repair (18%). Comparing three time periods (1985, 86, 87) no significant amelioration of complication rates were found. But factors influencing complications like very high age of patients, seriousness of the disease, and diabetes were not evenly distributed in all three samples. Therefore it might be impossible to lower the complication rate since those factors can't be influenced by better preparation for and better performing of surgery.
Rohde
H
H
Chirurgische Abteilung, Krankenhaus der Augustinerinnen, Köln.
Heistermann
S
S
Viehoff
G
G
D005860:Germany, West; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D011785:Quality Assurance, Health Care / Q000639:trends*; D012307:Risk Factors; D013503:Surgery Department, Hospital; D013530:Surgical Wound Infection / Q000517:prevention & control
Systematische Erfassung postoperativer Komplikationen. Eine Form der Qualitäts-Selbstkontrolle.