[A transparent, internal complication management concept: results and consequences].
BACKGROUND
The acquisition of data and public discussion of complications after therapeutic procedures and surgeries is a sensitive subject, which is mostly avoided even in department meetings. However, it is evident that the broad discussion and the expression of different opinions and aspects provide useful information for continuous improvements. Therefore, we established a system for the transparent acquisition of complications in our department.


METHODS
Since January 2005, we systematically register operative and non-operative complications at our department, evaluate them and therefore gain a great benefit. All the complications are presented, discussed and evaluated within the weekly morbidity and mortality conferences.


RESULTS
In 2005 and 2006, among a total number of 2730 and, respectively, 3124 operations, 102 (3.7 %) and 71 (2.3 %) complications have been registered and analysed according to different criteria. We have distinguished between complications which required surgery and complications which only required conservative treatment. There was a higher number of complications which needed surgery. In this group, the most common complications have been found in vertebral spine surgery. The groups of complications with conservative treatment were mostly related to nerve lesions and deep venous thrombosis. With the aid of the internal department evaluation of the registered data, especially the number of complications in vertebral spine surgery could be clearly reduced in 2006.


CONCLUSIONS
The described method has created a transparency of occurring complications because each colleague is informed as well as involved in the solution process. Furthermore, it is planned to evaluate the impact of risk factors on the various performed surgeries.
Wagner
G
G
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, Frankfurt am Main. gilbert.wagner@kgu.de
Gritzbach
B
B
Frank
J
J
Marzi
I
I
D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D008297:Male; D019221:Mandatory Reporting; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*