Issue |
J Extra Corpor Technol
Volume 44, Number 1, March 2012
|
|
---|---|---|
Page(s) | 26 - 33 | |
DOI | https://doi.org/10.1051/ject/201244026 | |
Published online | 15 March 2012 |
Original Articles
Developing a Benchmarking Process in Perfusion: A Report of the Perfusion Downunder Collaboration
* Cardiac and Thoracic Surgical Unit, Department of Medicine, Flinders Medical Centre and Flinders University of South Australia, Adelaide, South Australia, Australia
† Cardiothoracic Surgical Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia
‡ Perfusion Services, Cabrini Health, Melbourne, Victoria, Australia
§ Green Lane Perfusion, Auckland City Hospital, Auckland, New Zealand
¶ Professor and Head of Department of Anaesthesiology, School of Medicine, Auckland University, Auckland, New Zealand
Address correspondence to: Robert A. Baker, PhD, CCP (Aust), Director, Cardiac Research and Perfusions, Cardiac and Thoracic Surgery, Flinders Medical Centre and Flinders University, Level 6 Flinders Medical Centre, Flinders Drive, Bedford Park, Adelaide, South Australia 5042. E-mail: Rob.Baker@flinders.edu.au
Received:
14
December
2011
Accepted:
13
February
2012
Improving and understanding clinical practice is an appropriate goal for the perfusion community. The Perfusion Downunder Collaboration has established a multi-center perfusion focused database aimed at achieving these goals through the development of quantitative quality indicators for clinical improvement through benchmarking. Data were collected using the Perfusion Downunder Collaboration database from procedures performed in eight Australian and New Zealand cardiac centers between March 2007 and February 2011. At the Perfusion Downunder Meeting in 2010, it was agreed by consensus, to report quality indicators (QI) for glucose level, arterial outlet temperature, and pCO2 management during cardiopulmonary bypass. The values chosen for each QI were: blood glucose ≥4 mmol/L and ≤10 mmol/L; arterial outlet temperature ≤37°C; and arterial blood gas pCO2 ≥ 35 and ≤45 mmHg. The QI data were used to derive benchmarks using the Achievable Benchmark of Care (ABC™) methodology to identify the incidence of QIs at the best performing centers. Five thousand four hundred and sixty-five procedures were evaluated to derive QI and benchmark data. The incidence of the blood glucose QI ranged from 37–96% of procedures, with a benchmark value of 90%. The arterial outlet temperature QI occurred in 16–98% of procedures with the benchmark of 94%; while the arterial pCO2 QI occurred in 21–91%, with the benchmark value of 80%. We have derived QIs and benchmark calculations for the management of several key aspects of cardiopulmonary bypass to provide a platform for improving the quality of perfusion practice.
Key words: cardiopulmonary bypass / quality indicator / cardiac surgery
© 2012 AMSECT
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