Value-driven cardiac surgery: Achieving “perfect care” after coronary artery bypass grafting

Glotzbach, Jason P.; Sharma, Vikas; Tonna, Joseph E.; Pettit, Jacob; McKellar, Stephen H.; Eckhauser, Aaron; Varghese, Thomas K.; Selzman, Craig H.

doi:10.1016/j.jtcvs.2018.03.177

Cited by 15 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Today, the ICHOM working group stipulates that the intention of such parameterization is not to devise new measures of results but rather to agree on a well-assessed outcome measure indicator that everyone should use to cover a much broader spectrum of the outcome hierarchy for a health condition ( ICHOM, n.d. ). The use of the ICHOM questionnaires in the literature is still restricted to a few studies concentrated in the fields of orthopedic surgery ( Berglund et al, 2019 ; Glotzbach et al, 2018 ; Pelt et al, 2016 ), general practice ( Hernandez et al, 2019 ; Kulkarni et al, 2011 ), bariatric surgery ( Noria et al, 2015 ), obstetrics ( Van Den Berg et al, 2020 ), breast cancer ( van Egdom et al, 2019 ), and prostate cancer ( Thaker et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Value-Based Healthcare Initiatives in Practice: A Systematic Review

Zanotto¹,

Etges²,

Marcolino³

et al. 2021

Journal of Healthcare Management

View full text Add to dashboard Cite

EXECUTIVE SUMMARY Value-based initiatives are growing in importance as strategic models of healthcare management, prompting the need for an in-depth exploration of their outcome measures. This systematic review aimed to identify measures that are being used in the application of the value agenda. Multiple electronic databases (PubMed/MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials) were searched. Eligible studies reported various implementations of value-based healthcare initiatives. A qualitative approach was used to analyze their outcome measurements. Outcomes were classified according to a tier-level hierarchy. In a radar chart, we compared literature to cases from Harvard Business Publishing. The value agenda effect reported was described in terms of its impact on each domain of the value equation. A total of 7,195 records were retrieved; 47 studies were included. Forty studies used electronic health record systems for data origin. Only 16 used patient-reported outcome surveys to cover outcome tiers that are important to patients, and 3 reported outcomes to all 6 levels of our outcome measures hierarchy. A considerable proportion of the studies (36%) reported results that contributed to value-based financial outcomes focused on cost savings. However, a gap remains in measuring outcomes that matter to patients. A more complete application of the value agenda by health organizations requires advances in technology and culture change management.

show abstract

Section: Discussionmentioning

confidence: 99%

Value-Based Healthcare Initiatives in Practice: A Systematic Review

Zanotto¹,

Etges²,

Marcolino³

et al. 2021

Journal of Healthcare Management

View full text Add to dashboard Cite

show abstract

“…69 By using VDO and identifying institutionand patient-specific metrics of "perfect care" and appropriate clinical pathways, the University substantially lowered the cost of CABG and improved its outcomes. 70…”

Section: Value-based Carementioning

confidence: 99%

Evaluating Quality in Adult Cardiac Surgery

Sharma

Glotzbach

Ryan

et al. 2021

Texas Heart Institute Journal

Self Cite

View full text Add to dashboard Cite

National and institutional quality initiatives provide benchmarks for evaluating the effectiveness of medical care. However, the dramatic growth in the number and type of medical and organizational quality-improvement standards creates a challenge to identify and understand those that most accurately determine quality in cardiac surgery. It is important that surgeons have knowledge and insight into valid, useful indicators for comparison and improvement. We therefore reviewed the medical literature and have identified improvement initiatives focused on cardiac surgery. We discuss the benefits and drawbacks of existing methodologies, such as comprehensive regional and national databases that aid self-evaluation and feedback, volume-based standards as structural indicators, process measurements arising from evidence-based research, and risk-adjusted outcomes. In addition, we discuss the potential of newer methods, such as patient-reported outcomes and composite measurements that combine data from multiple sources.

show abstract

“…4 These efforts have significantly benefited patients but have come at a substantial cost to systems across the world, where fee-for service models of reimbursement have prevailed. 5 Health care costs have therefore skyrocketed, exceeding gross domestic product growth in some countries between 2016 and 2017, 6 making it imperative for governments to find mechanisms to curb spending while simultaneously trying to extend coverage to the majority of the population. This has led to a tendency to move health care reimbursement from fee-for-service to fee-for performance in the form of disease-specific payments, forcing institutions to engage in models that reinforce value-driven care.…”

Section: Vinay Badhwar MDmentioning

confidence: 99%