QUALITY ASSURANCE IN ARTHROPLASTIES

Background: To evaluate the level of documentation as an instrument of ongoing quality management in arthroplasty, a questionnaire was creat ed on this subject, which concentrated on structural and process indic ators. Methods: A total of 908 questionnaires was sent to orthopedic a nd trauma departments in Austria, Germany and Switzerland and were eva luated anonymously. Results: The quota of return was 54% in Switzerlan d, 47% in Austria and 25% in Germany. The waiting period for an arthro plasty is much less in Switzerland and in Germany than in Austria. Onl y 40% of patients receive forms for informed consent. Documentation is seldomly standardized thus making comparison virtually impossible. Su rgical planning is usually done with templates in Germany and Austria, in Switzerland with drawings. Prosthesis passports are predominately used by orthopedic departments. The data regarding complication rates and infections are not analyzed at regular intervals (max. 30%) and co rrective measures are rarely implemented. Conclusion: Documentation is the basic instrument of quality management and requires completeness (totality) and plausibility of the datas. It is of great importance th at evaluated data are analyzed and consequences are taken. The primary aim of quality assurance is to identify problems that adversely affec t quality in order to develop and implement process sequences for the improvement of patient care and management.