[PDCA cyclus and morbidity and mortality conference as a basic tool for reduction of wound infection in colorectal surgery].
BACKGROUND
Morbidity and mortality conferences (M + M) are used for the discussion of errors and thereby further education in surgery. However, it is not clear whether this kind of quality assurance has any influence on the results of surgery.


METHODS
We investigated whether M + M as part of PDCA-cylce (plan, do, check, act) with prospectively collected quality data, fixing future goals using benchmarking data and defining a strategy to reach these goals can lead to an increase in quality.


RESULTS
Using surveillance data n = 673 colorectal resections were analysed. Between 2003 and 2008 we found a wound infection rate of 5.6 %. Comparing 2003-2005 (period of strategy development using M + M) and 2006-2008 (period of strategy conversion) the frequency decreased from 7.8 % to 3.5 % (p = 0.012). Thereby the risk factors for wound infection (ASA, wound classification, duration of surgery and wound infection score) were not different.


CONCLUSIONS
M + M as part of this PDCA cycle resulted in a clear increase in surgical quality.
Vogel
P A
PA
Klinikum Friedrichshafen GmbH, Chirurgie I, Friedrichshafen, Deutschland. peter.vogel@akh-celle.de
Vassilev
G
G
Kruse
B
B
Cankaja
Y
Y
D000368:Aged; D019072:Antibiotic Prophylaxis; D019985:Benchmarking / Q000592:standards; D057189:Checklist; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019990:Perioperative Care / Q000592:standards; D011446:Prospective Studies; D058996:Quality Improvement / Q000592:standards*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000401:mortality* / Q000517:prevention & control*