Quality assurance in arthroplasties

Background: To evaluate the level of documentation as an instrument of ongoing quality management in arthroplasty, a questionnaire was created on this subject, which concentrated on structural and process indicators. Methods: A total of 908 questionnaires was sent to orthopedic and trauma departments in Austria, Germany and Switzerland and were evaluated anonymously. Results: The quota of return was 54% in Switzerland, 47% in Austria and 25% in Germany. The waiting period for an arthroplasty is much less in Switzerland and in Germany than in Austria. Only 40% of patients receive forms for informed consent. Documentation is seldomly standardized thus making comparison virtually impossible. Surgical 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 corrective 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 that evaluated data are analyzed and consequences are taken. The primary aim of quality assurance is to identify problems that adversely affect quality in order to develop and implement process sequences for the improvement of patient care and management.