Noblesse oblige-The pediatric surgeon (h)as the key to quality control and improvement

The trust crisis in health care demands action by health care professionals. Trust is based on quality, candor, and accountability. The pediatric surgeon, as the expert in the field, should be in control of quality management. By improving quality, the trust in the health care system can be restored. Quality is defined as being on target with minimal variation. To assess these targets, performance indicators have been developed by the Association of Pediatric Surgeons in The Netherlands for 7 neonatal conditions. Variation can be distinguished as special-cause and common-cause variation using the control chart method of Walter Shewhart. The various activities in this field that have been developed and are ongoing in The Netherlands are presented.