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Assessing quality in cardiac surgery: why this is necessary in the twenty-first century
1Gill Heart Institute, University of Kentucky College of Medicine, Lexington, USA. jswain@hq.nasa.gov
Insights
Accurate data collection and interpretation are vital for improving quality in cardiac surgery. Continuous efforts by the entire surgical team ensure meaningful application of quality metrics.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Medical Data Analytics
Background:
- Coronary surgery faces public scrutiny due to high costs and profile.
- Cardiac surgeons have pioneered data collection and risk analysis in this field.
- Accurate interpretation of surgical data is a critical issue.
Purpose of the Study:
- To review the history and background of risk adjustment in cardiac surgery.
- To examine the utilization of quality data in surgical outcomes.
- To discuss factors including cost and outlier management in surgical quality.
Main Methods:
- Historical review of risk adjustment methodologies.
- Analysis of quality data in cardiac surgery.
- Examination of observed/expected mortality ratios.
- Discussion of economic factors and outlier responses.
Main Results:
- Significant data and risk analysis information exist within cardiac surgery.
- Interpreting this data correctly is identified as a key challenge.
- Observed/expected mortality ratios and cost implications are important considerations.
Conclusions:
- Continued accurate data collection by the entire operative team is essential.
- A strong commitment to quality improvement is crucial for effective data application.
- Meaningful application of quality data requires ongoing team effort and dedication.
Abstract:
The cost and high-profile nature of coronary surgery means that this is an area of close public scrutiny. As much pioneering work in data collection and risk analyses has been carried out by cardiac surgeons, substantial information exists and the correct interpretation of that data is identified as an important issue. This paper considers the background and history of risk-adjustment in cardiac surgery, the uses of quality data, examines the observed/expected mortality ratio and looks at issues such as cost and reactions to outliers. The conclusion of the study is that the continuation of accurate data collection by the whole operative team and a strong commitment to constantly improving quality is crucial to its meaningful application.