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Eur J Cardiothorac Surg 2006;29:697-698
© 2006 Elsevier Science NL

Editorial comment

Online performance monitoring in cardiac surgery

Cardiac Surgery Department, Leuven University Hospital Gasthuisberg, Leuven, B-3000, Belgium

^_* Corresponding author. Tel.: +32 16 344 339; fax: +32 16344616. (Email: Paul.Sergeant@uz.kuleuven.ac.be).

The first 20% of the full text of this article appears below.

Kang et al. [1] have created an interesting manuscript, of interest not only to experts in quality control or congenital surgery but also to all of us wanting cardiac surgery to sustain in this challenging world.

Indeed we are active in labour-intensive environments where cost-containment and cost-control challenge any use of human or material resource; irrelevant if this challenge is imposed by hospital administrations or self-imposed. The second challenge is the increased expectation of total absence of periprocedural risk as well by patient as society. Their perception of absence of risk is substantiated in legal persecutions and the concomitant explosion of insurance protection. Our third fundamental challenge is the improved results of nonsurgical interventional but also of noninterventional therapies.

This impacts the mandatory processes of evolution of our profession. John Kirklin proposed in the second part of the 20th century his concept of incremental improvements. Surgeons should try to improve gradually every step or detail of their medical production process. There was very little risk of underperformance in this minimal-difference evolution, because Kirklin added the registration of the surgical process descriptive . . . [Full Text of this Article]