Systemic quality assurance in surgery

Between April 1993 and December 1995 the perioperative courses of 3183 patients were recorded within the frame work of a quality assurance project at the Department of Surgery, University of Mainz. The age of the operated patients and the rate of morbidity increased significantly during the observation period. Morbidity and mortality were not correlated to increasing need for intensive care. Morbidity was dependent on the surgical approach and also on the surgeon. On the other hand, high numbers of operations did not necessarily correlate with low complications rates. The concept described makes it possible to compare quality assurance among different hospitals, helps surgeons to recognize and improve their weak points, and serves as an additional method for monitoring the quality of treatment in the clinic.