Establishing and Using a Local/Regional Cardiac Surgery Database

Evolução da cirurgia cardiovascular no Instituto do Coração: análise de 71.305 operações

“…In this context, it is needless to stress importance of good quality health information system to guide formulation and evaluation of policies for our area and, especially, to enable society to monitor and evaluate efforts directed to such activities and results obtained². One of the proposals of collecting data from cardiovascular surgical procedures is the possibility to obtain reference bases of its practices, in which the institution, as a whole, and each surgeon, individually, can improve their qualities and their results [3][4][5] .…”

Regional Collaborations as a Tool for Quality Improvements in Surgery

“…As seen in Table 1, a total of 7 collaborative initiatives were identified and included in the systematic review of the evidence. [15][16][17][18][19][20][21] Additional information on the collaborative initiatives was also identified in fifteen published or unpublished sources. [22][23][24][25][26][27][28][29][30][31][32][33][34][35] From the selected articles, information about the clinical domain, objectives, participants, sponsorship, support, infrastructure, methodology, social context, and sustainability were identified.…”

“…21 Six of the 7 collaborations appeared to have been planned as time-limited pilot or demonstration projects 15,16,18 -21 although it also appears that in 4 collaborative efforts, specific elements of the collaboration were sustained in an ongoing and modified program. 15,16,19,20 A clear exception is the Northern New England Cardiovascular Disease Study Group, a consortium of clinicians, administrators, and scientists founded in 1987 that continues to be active today. 17 …”

“…15 In 2 collaborative initiatives, state or regional requirements to evaluate the purchase of health services based on outcomes data motivated the establishment of improvement projects. 19,20 In contrast, 4 collaborative initiatives 16 -18,21 focused primarily on improving quality of care; the latter 2 having a particularly strong focus on achieving the uptake of best evidence in clinical practice. Regardless of the motivation or external stimulus at the outset, it would appear that once established, the ongoing collaborations set their own agendas with respect to data management, prioritization, and implementation.…”

Risk Prediction and Outcome Analysis

“…The Pennsylvania Health Care Cost Containment Council has databases that include hip and knee replacement, diabetes and health-associated infections, besides cardiac care [11]. Other states have followed, with a statewide approach to quality, such as the State of New Jersey Department of Health and Senior Services Office of Health Care Quality Assessment [12], the Minnesota Cardiac Surgery Database [13], the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative [14], and the Virginia Cardiac Surgery Quality Initiative [15].…”