Clinical audits are used to measure and improve quality of care. Since 2013 all patients undergoing aortic abdominal aneurysm (AAA) surgery in the Netherlands are registered Dutch Surgical Aneurysm... Show moreClinical audits are used to measure and improve quality of care. Since 2013 all patients undergoing aortic abdominal aneurysm (AAA) surgery in the Netherlands are registered Dutch Surgical Aneurysm Audit (DSAA). Where postoperative mortality was originally the primary outcome measure of this audit, due to low event rates this turned out to be indistinguishable between hospitals and did not provide any leads for quality improvement. With the aim of improving the quality of AAA surgery, new quality measures regarding the indication for surgery, choice of treatment and surgical outcomes were investigated in this thesis.Following the example of the DSAA, the Dutch Audit for Carotid Interventions (DACI) was initiated to monitor quality of care in patients undergoing carotid interventions. In this thesis the results of patients with a symptomatic carotid artery stenosis undergoing surgery during the first years of auditing are described. Show less
The Dutch Audit for Treatment of Obesity (DATO) provides individual and composite outcome measures, assessing the short-term postoperative outcome after bariatric surgery, enable the possibility to... Show moreThe Dutch Audit for Treatment of Obesity (DATO) provides individual and composite outcome measures, assessing the short-term postoperative outcome after bariatric surgery, enable the possibility to identify outliers. Most importantly, individual hospitals can identify differences in outcome, whereas these may remain hidden in daily practice. This between-hospital variation may initiate an improvement cycle. This will probably result in hospital and surgical quality improvements leading to improved outcomes in bariatric surgery. Show less
