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An introduction to quality assurance with an application for perfusionists.

Cardiovascular perfusionists have always been interested in quality assurance (QA), most often in the form of equipment maintenance and record keeping. However, these activities have tended to be fragmented. In an attempt to define a more global approach to QA, basic concepts are identified and the steps used to start a formal QA program are illustrated. In the usual approach to QA, three areas are commonly assessed: Structure, Process, and Outcome. Structure evaluates the adequacy of facilities and personnel. Process involves review of the activities concerned with the management of patients. Outcome represents evaluation of the end points of care. In starting our formal QA program, five steps were delineated. These were planning the program, setting up an administration, assessing preexisting activities, initiating the program, and finally evaluating results. A QA specialist helped to define a number of concerns about perfusion from perfusionists, surgeons, anesthesiologists, and nurses. Using a standard approach to QA, these areas were defined according to Structure, Process, and Outcome.