Quality Improvement
FEEL THE QUALITY Theo de By, the Director of EUROMACS and Project Manager of the Adult Cardiac Database, explains the ideas behind both projects and how they work.
What is EUROMACS?
Quality improvement is a vital and constant issue in the world of professional healthcare – it’s about improving systems and processes with the ultimate aim of securing better outcomes for patients. EACTS has taken a lead in driving quality improvement in cardiothoracic surgery and has established a Quality Improvement Programme (QUIP) that promotes the importance of integrating quality improvement initiatives into daily clinical practice, which, in turn, advances improvements in clinical outcomes. QUIP comes under the EACTS Quality Improvement and Databases Committee. Under QUIP, EACTS operates two key international databases: EUROMACS (the European Registry for Patients with Mechanical Circulatory Support), which collects data on patients receiving mechanical circulatory support; and the Adult Cardiac Database, which seeks to benchmark data from hospitals across Europe as a way to improve pre- and post-operative care.
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“EUROMACS is a registry that has been set up to gather data from participating centres and to accumulate the data into a database that can be used by researchers and clinicians to correlate the different factors that influence outcomes. Results in patients with different diagnoses and treatment modalities can be compared. Outcomes per individual centre can be benchmarked against all other centres. The patients in the database are mostly candidates for heart transplantation. To overcome the period between diagnosis of heart failure and transplant an assist device is implanted. The device helps them to keep the blood circulation intact until a heart for transplant becomes available. A small category of patients will never get a transplant but do get an assist device, e.g. because of advanced age. We use EUROMACS to understand the different influences of the treatment strategies that are used with these patients on the survival, on adverse events, to see how clinicians can perhaps avoid such events.”
So EUROMACS is helping the scientific community to understand how to support these patients? “Yes, and it goes into deep detail sometimes. We have many different clinical baseline and follow-up data which, for the physicians involved in analyses of these data can be indicators for treatment options.”
How many centres are participating? “We have 70 centres contributing data to EUROMACS. This includes national societies, for instance, the Spanish, and there is an understanding with the French SFCTCV to join the registry, while all centres in the Netherlands share 100% of their data.”
