• van BoxtelAstrid G MAGMDepartment of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands., Dennis van Veghel, Mohamed A Soliman Hamad, Daniela N Schulz, Pieter S Stepaniak, and van StratenAlbert H MAHMDepartment of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands..
• Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands.
• Interact Cardiovasc Thorac Surg. 2017 Oct 1; 25 (4): 555-558.

ObjectivesWe have implemented an intraoperative checklist aiming to reduce the incidence of re-exploration for bleeding after cardiac surgery. The present report addresses the results of adopting such a checklist regarding the incidence of postoperative bleeding.MethodsThe checklist was implemented by presenting it in several staff meetings of the Catharina Heart Center. Copies of the checklist were presented in every operating room. Data were collected by the Catharina Heart Center, aligned with the 'Meetbaar Beter' data manual and validated by 'Meetbaar Beter' through their data quality system. The incidence of re-exploration for bleeding was analysed in a variable life-adjusted display curve. The patient population operated after the implementation of the checklist was compared with a recent historical population before its implementation.ResultsFrom January 2013 through April 2016, 4817 cardiac surgical procedures were performed in our institution. Before May 2015, 3210 procedures were performed (Group 1), complicated by 112 re-exploration for bleeding (3.5%). The 'reoperation for bleeding checklist' was implemented on 1 May 2015. After this date, the number of re-explorations for bleeding decreased to 29 (1.8%) of the 1607 cardiac surgical procedures (Group 2) (P < 0.05).ConclusionsAn intraoperative checklist is feasible to implement, low cost, quick and simple to measure with a significant reduction in the incidence of re-exploration for bleeding. This report shows an example of the positive effects of transparency in publishing outcomes' data in cardiac surgery.© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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