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Objectives: The aim of this study was to apply control charts (CUSUM curves) to a surgical site infections (SSIs) surveillance system to enhance quality control after cardiac operations. Methods: A total of 3529 consecutive cardiac operations were performed from January 2007 to June 2011 in our institution. Data for active surveillance were obtained from telephonic post-discharge monitoring with a structured questionnaire, or from clinicians' alert reports. Institutional performance was monitored using descriptive statistics and with control charts, with a predetermined failure rate of 5%. Primary counter-measures in case of clusters of SSIs were: health professionals re-training on hand hygiene and sanitation and a preoperative education programme for patients and visitors. Results: The incidence of SSIs was 7.1%, comparing favourably with literature data. Institutional CUSUM analysis revealed that the surgical …