[Quality management in the heart catheterization laboratory].
Quality management within the catheterization laboratory includes the quality control, the heart catheterization technique and the policy. Quality management is critical in the heart catheterization laboratory. Dedication of all members of the lab and computer personnel ensures high patient satisfaction. A continued quality improvement program is patient-orientated and requires good planning. One of the main emphasis in the catheterization lab is standardization which includes the patient preparation, the procedure itself, and the management. It is supported by teamwork including the economic aspect of prompt delivery of material and avoidance of complications. A continuous circle of treatment planes, performance, and check is regarded as the Deming cycle and leads to continuous improvement of quality. Important are both the avoidance and detection of complications. The reasons for any such have to be evaluated. It is recommended to follow the zero mistake hypothesis of Crosby, which means quality control by the lab supervisor, a quality consciousness, a quality measurement and quality improvement, as well as using a day to day quality improvement and to teach quality control. In Germany a quality control questionnaire was administered in an analysis of the current structure, function, and results of catheterization labs. Most important was the analysis of complications. The data were based on diagnostic catheterization in 1992, which included 140668 catheterizations in 83 laboratories. Thus, a mean of 1030 heart catheterizations was performed in each lab. In the mean, 200 catheterizations were performed by each doctor. In 19% of the labs digital imaging was exclusively performed. Major complications occurred with ventricular fibrillation in 0.36% (range 0.75%), resuscitation 0.18% (0.43%), persistent cerebrovascular accident 0.08% (0.24%), myocardial infarcts 0.19% (0.59%), aortic dissection 0.05% (0.22%). Mortality was 0.03% (0.08%). In heart catheterization laboratories quality management is one of the major goals for the future work. Only the continued improvement of quality and very good quality management ensure patient safety. Quality is the sum of technique and consciousness.
Erbel
R
R
Abteilung Kardiologie Medizinische Klinik und Poliklinik Universität-GHS Essen.
Sommerfeld
U
U
Ashry
M
M
Haude
M
M
D006328:Cardiac Catheterization / Q000401:mortality / Q000592:standards*; D002309:Cardiology / Q000193:education; D002423:Cause of Death; D003479:Curriculum; D005858:Germany; D006801:Humans; D010347:Patient Care Planning / Q000592:standards; D010348:Patient Care Team / Q000592:standards*; D011785:Quality Assurance, Health Care; D011786:Quality Control; D011835:Radiation Protection / Q000592:standards; D012307:Risk Factors
Qualitätsmanagement im Herzkatheterlabor.