Peer review and quality assurance in cardiac surgery in Australia.

There is increasing community and government interest in determining the quality of medical performance in Australia. This means that any lead taken by the Australasian Society of Cardiac and Thoracic Surgeons (ASCTS) in defining and adopting performance indicators for the profession is appropriate and timely. The ASCTS Peer Review Committee has examined the issue of quality management, and presents here several key indicators and a draft program of remediation which, if adopted, will facilitate the achievement of the highest and most uniform surgical standards for Australia. The Committee recommends the monitoring of just one procedure initially: coronary artery surgery. The Committee sees the quality management program as involving both surgeons and hospital-based quality assurance teams. Ultimately, the profession will gain from performance measurement by being able to minimise inappropriate variations in practice. The community will benefit by having national and international best practice in cardiothoracic surgery, with surgeons being able to identify more easily those procedural changes that result in superior as well as inferior outcomes.