Implementing Benchmarking in Perfusion Practice: Results of a Multicentre Quality Improvement Initiative

Background: The Perfusion Downunder Collaboration (PDUC) has established a multi-centre perfusion focused database with the objectives of measuring and reporting clinical practice, and to facilitate clinical improvement through the introduction of benchmarking of quantitative quality indicators.

Methods: Data were collected using the PDUC database from procedures performed in eight Australian and New Zealand cardiac centres between March 2007 and February 2012. Benchmarked quality indicator's (QI) of cardiopulmonary bypass (CPB) management 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 incidence of QI in our baseline procedural cohort (2007–2011) was compared with procedures after the introduction of benchmarking.

Results: 7877 procedures were evaluated to compare the incidence of QI before and after the introduction of benchmarking. The incidence of the blood glucose QI improved from 67% to 75% of procedures, with a benchmark value of 93.4%. The arterial outlet temperature QI improved from 61% to 75% of procedures with the benchmark of 99.7%; while the arterial pCO2 QI improved from 57 to 60%, with the benchmark value of 83.9%.

Conclusions: Participation in a multicentre perfusion database that incorporates quantitative quality indicators facilitates clinical improvement through benchmarking.