PDCA-Zyklus und Morbiditäts- und Mortalitätskonferenz als Basis der Wundinfektionsreduktion in der Kolorektalchirurgie

Abstract

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. 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. 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. M + M as part of this PDCA cycle resulted in a clear increase in surgical quality.