Structure of a general thoracic surgery in Europe

This document Presents a professional view of the optimal organization of General Thoracic Surgery (GTS) in Europe. It is intended as guidance to national governments and regional authorities and has been approved by the Councils and confirmed by the General Assemblies of the European Association for Cardio-thoracic Surgery REACTS) and the European Society of Thoracic Surgeons (ESTS). Together. these societies represent the majority of European surgeons specialising, in GTS. Current facilities and arrangements for the care of thoracic Surgical patients are of variable quality throughout Europe with experience. work-load and resources being sometimes below an acceptable level. A structure is foreseen with some GTS units being larger and having advanced with major thoracic surgical programs, providing subspeciality services such as transplantation (so called units of higher specialization). These units would also possess research facilities and cater for advanced educational needs within the speciality. Smaller units Would be more generally distributed and would provide a more standard care still with sufficient numbers of patients to achieve a sound overall level of expertise in thoracic surgery (so called units of standard). In both types of units the infrastructure should be orientated around patient needs and should encompass such features as: quality assurance, data collection in a European Registry. risk stratification, reciprocal voluntary audits. individualised surgical results, collaboration in clinical research. structured continued education and re-certification. The same specific expertise and organisational background should apply to other members of the team caring tor thoracic surgical patients. especially anaesthetic, nursing and physiotherapy personnel. A larger amount of patients in each unit will allow for dedicated operating room. intensive care and general ward facilities. These outlined measures are expected to result not only in an improved quality of patient care European wide. but also in an improved cost-efficiency of GTS. To guarantee quality of education and recertification a European Board of Thoracic and Cardiovascular Surgeons (EBTCS) has been established. which is offering examinations in cardio-thoracic as well as thoracic surgery.