A national cardiac surgery database: Current achievements and future challenges

Abstract

0 ver the past 5 years, the Australasian Society of Cardiac and Thoracic Surgeons (ASCTS) has intensified its efforts to establish a national database to cover all cardiac and thoracic surgical procedures carried out in Australia. Initially, the aim was to retrieve data on all adult patients having cardiac surgery in a public hospital. The ultimate aim will be to include private patients, paediatric patients and patients undergoing thoracic surgical procedures. The push for a comprehensive, risk-adjusted and interactive database has come about because of a number of factors, such as the lack of risk-stratification and the publishing delays with the current Australian Institute of Health and Welfare (AIHW) Cardiac Surgery Register, and an awareness that comparably developed countries (predominantly the USA and Western European countries) already have workable, if not comprehensive, databases. An important aim of the National Cardiac Surgery Database is to ensure that high quality cardiac surgery is being carried out in this country, and that the results of this surgery are being recorded and published. A secondary aim is to establish a peer review mechanism. The process of ensuring quality at an individual and unit level is one that the cardiac surgical community has been grappling with for some time. The need to identify poor performance if it occurs, is one that we can no longer avoid in the current political climate.