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Quality assurance in interventional cardiology
  1. John Perrins

    President, British Cardiovascular Intervention Society

  1. Leeds General Infirmary, Jubilee Wing, Great George Street, Leeds LS1 3EX, UK
  1. Dr Perrins

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The British Cardiovascular Intervention Society (BCIS) exists to aid the development and practice of percutaneous cardiac intervention in the UK. As such it has responsibilities to individuals who practise as well as responsibilities to their patients, departments, and hospitals. Quality assurance, peer review, and individual audit highlight the tensions between the society’s responsibilities to individual practitioners and its wider responsibility to patients more sharply than any other activity of the society. However BCIS council strongly believes that proper quality assurance is the most effective way it has of supporting individual operators and departments throughout the UK.

BCIS began as a voluntary group of individual physicians who met to discuss case histories and issues relating to this rapidly growing field. As the speciality grew and matured so has the society, which now has several important functions.

BCIS represents all interested parties, including physicians, technicians, nurses, and regulatory bodies, and has a very strong association with industry through the British Cardiovascular Industry Association.
BCIS has an important role in teaching in its support and organisation of the yearly advanced angioplasty and regional autumn meetings, and by promoting many other educational activities throughout the year, of which this supplement is one.
BCIS, together with the other affiliated groups, has formally joined with the British Cardiac Society such that BCIS has a representative sitting on the British Cardiac Society council. In addition, all guidelines produced by BCIS are now approved by the council of the British Cardiac Society before publication.
Most importantly BCIS has a key role in determining the standards of care which interventionists and their teams should be providing for their patients. In 1996 a joint working group between the British Cardiac Society and BCIS set out guidelines for training and continuing competence in coronary angioplasty.1 This first document provoked much discussion and criticism but its general acceptance has defined BCIS’s role in this area. Over the last two years, a second joint working group has updated the recommendations and outlined the requirements for optimal modern practice. This document, shortly to be published in Heart, not only covers training and continuing competence but also addresses the infrastructure required for good practice and highlights the importance of audit and peer review.2

For many years, BCIS has collected data on an annual basis that has been used for tracking the growth of the specialty. The early work of Peter Hubner and then Huon Gray encouraged all departments to submit voluntarily some data to BCIS. The data were largely related to procedure volumes, centre numbers, etc. Attempts were made to determine clinical outcomes after coronary intervention, but it became apparent that there were many flaws. The current public and political interest in outcomes after medical interventions will undoubtedly accelerate the process that BCIS has been advocating for many years. It is no good just providing good clinical practice; we have got to beseen to provide good clinical practice. For the determination of standards against which activity can be monitored, the society believes in a process run by the profession for the profession and believes that self regulation is the only methodology suitable for this process. The concept of non-medical regulation of standards …

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