Tayyab Pasha, Amer Iqbal, Ahmed Saleem.
Quality measurement in adult cardiac surgery at Jinnah Hospital according to STS-Standard.
J Allama Iqbal Med Coll Jan ;7(4):1-6.
Quality measurement is an essential component of quality care improvent and health care reforms. Quality is an abstract construct which cannot be measured directly like music and intelligence. So in current practice to analyze quality we have to use combination of structure, process and outcome measures. STS database is one of the largest comprehensive single specialty database having information on all aspects of adult cardiac procedures covering all domains. We have developed the latest version of STS data base (2.52) according to the guidelines provided by the society of thoracic surgeon. STS established a quality measurement task force to develop a methodology for comprehensive assessment of coronary artery bypass surgery We followed the same guidelines as provided by the QMTF and were able to look for quality measurement at Jinnah Hospital according to the international standard. We have performed more than 200 open hearts in 18 months and out of these 126 are coronary artery bypass. For Analytical assessment. All or none principle in peri-operative care and any or none principle in outcome measure were used according to QMTF guidelines. From process measured point of view in peri-operative care regarding preoperative and postoperative use of medicines according to “All or none principle” we are close to STS standard 75% but these is room for improvent. Use of at least single mammry artery was done in all CABG patients except one. While risk adjusted operative mortality was less than 1%. Which is an equal to above averge performing centre according to STS standards, On the other hand only 5 patients were explored for bleeding and 3 patients were in need of prolonged ventilation and there was one case of deep wound infection..
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