More than a half million patients undergo open-heart surgical procedures annually in the United States to extend their life or relieve symptoms from their coronary or valvular heart disease. Several cardiac surgical quality improvement collaboratives have emerged whose focus has been to leverage data derived from regional and national registries to measure, organize and improve cardiothoracic surgical care. These collaboratives have focused their activities in a number of areas, including: clinical decision-making (development and implementation of risk prediction models), observational epidemiology (identifying variation in clinical care and its consequences), quality improvement (identification of """"""""upstream"""""""" process measures statistically linked to improved outcomes), and public reporting (transparency of performance measures). While shared missions conceptually link these clinical collaboratives, there has never been an opportunity for cross-fertilization between these groups. The development of a network of regional cardiothoracic surgical collaboratives [herein called the IMPROVEment (IMPROVE) Network] would provide opportunities for leveraging each collaborative's strengths, whether cost containment, risk adjustment, study design, engagement of payers, or supporting quality improvement teams, to improve the safety and value of cardiac surgical care across the IMPROVE Network. A number of issues (related to structure, function, data ownership, communication and financing) must be addressed to facilitate the development of the IMPROVE Network. Identifying the set of obstacles as well as solutions will form the focus of two planning conferences to develop a novel structure for developing new lines of research inquiry and conducting quality improvement studies. We seek to convene representatives from each collaborative twice during the current proposal. During the first session, we will identify aspects of overlap across existing collaboratives and develop the foundation (mission, vision, structure and financing) for the proposed IMPROVE Network in the form of a white paper. Subsequent to this inaugural meeting, each collaborative will distribute and seek comments from its membership on the white paper in preparation for the second conference. During the second conference, attendees will endorse the formation of the IMPROVE Network and develop the content for an R01 submission to AHRQ that would leverage the infrastructure gained through the development of this network.
More than a half million patients undergo open-heart surgical procedures annually in the United States to extend their life or relieve symptoms from their coronary or valvular heart disease. Several regional cardiac surgical quality improvement collaboratives have emerged to improve the quality of cardiac surgical care provided within their respective regions. The focus of this small conference project will be to establish a network for linking these collaboratives together to (1) develop and implement research and quality improvement projects, and (2) improve the safety and value of cardiac surgical care across their respective regions.
|Likosky, Donald S; Al-Attar, Paul M; Malenka, David J et al. (2014) Geographic variability in potentially discretionary red blood cell transfusions after coronary artery bypass graft surgery. J Thorac Cardiovasc Surg 148:3084-9|