Indian Society of Extracorporeal Technology

Indian Perfusionists

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Quality Improvement

Perfusionist can influence and improve different domains of cardiac surgery through a systematic application of quality improvement projects that dictate the ultimate goal of patient care. Evaluation tools will then be developed to help perfusionists estimate the impact of the applied strategies.

Quality Control

Quality control is defined as a set of activities or techniques whose purpose is to ensure that all quality requirements are being met. In order to achieve this purpose, processes are monitored and performance problems are solved.

Better Clinical Perfusion practice with continuous quality improvement

Protocols for Perfusion practice leads to better perfusion management in turn result in improved clinical outcomes for the cardiac surgical patients whose care we are charged with.

Quality Management and System which includes a Risk assessment framework - the best way of reducing error rates is to target the underlying system failures and root causes of incidents. Clinical perfusion is a complex practice with recognized inherent risks. Local practices, procedures or circumstances which potentially increase these risks need to be identified, assessed and rated with mitigating action identified.

Introduction of Quality control and Continuous Quality Improvement programs in improved adherence to institutional perfusion practice.

Protocols: Quality Indicators

  • Minimum Haemoglobin - 7 g/dl
  • Maintain pO2 above 100 mm Hg
  • Maintain pCO2 between 35 and 45 mm Hg
  • Minimum Arterial Pressure - 40 mmHg
  • Aim to keep Cardiac Index > 1.6 l/min/m2
  • Aim to keep Venous saturation > 60%
  • Maximum Arterial outlet temperature - 37.5OC

Quality Improvement

Every Perfusionist should participate and contribute to improving perfusion care delivered to patients. Quality improvement can be focused on different domains of Cardiopulmonary bypass practices like myocardial protection, priming protocols, cerebral and renal protection strategies, blood transfusion thresholds, strategies to minimize the impact of CPB and many more.

Evidence based quality improvement has to start with gathering evidence and knowledge and through consensus, goals for improvement will be described as well as the strategies that can be used to achieve these goals.

Literature Review

Exploring the literature on perfusion practice within the specific quality improvement domains aids in the development of clinical practices.

Guide to good practice in Clinical Perfusion - Quality Assurance

The perfusionist applies knowledge, principles and skills in the establishment and ongoing contribution of perfusion based quality assurance activities

  • Quality management document - Establishes and maintains a written and oral communication system for personnel, in order to support quality service.
  • Standard operating procedures.
  • Clinical perfusion protocols -Critically analyzes and evaluates clinical practice with colleagues.
  • Systematic checking and recording - Establishes procedures and protocols to measure quality of safe practice and records the data.
  • Participates in quality assurance activities of related health care members - Teamwork and human factors training
  • Risk assessment, Peer review.
  • Remains current with literature on quality assurance activities that improve patient care and perfusion practice.

Perfusion Database

To create a registry of perfusion practice developed from a consensus and evidence based dataset. To encourage data collection, based on literature and evidence, to be able to perform quality improvement initiatives.