Using Data to Improve Patient Care

STS/CATS/CSCS

Monday

11:30 a.m. – 12:30 p.m.

Room 351DEF

More than ever, cardiothoracic surgeons may feel as if they are under a microscope with increasing scrutiny of their performance from professional societies, patients, and employers. Today’s session from STS, the Canadian Association of Thoracic Surgeons, and the Canadian Society of Cardiac Surgeons will focus on bringing real-life quality improvement methods to cardiothoracic surgeons, their divisions, and the specialty.

Andrew J. Seely, MD, PhD, of the University of Ottawa in Ontario, Canada, will share how surgeons within the same group can help each other improve their performance. Dr. Seely developed a robust grading system—the Ottawa TM&M—and an in-house data collection tool designed specifically for data-driven quality improvement. He then adopted a novel concept, looking at the “positive deviants.” This method focuses on positive outliers and positive performers, rather than negative performers, said session co-moderator Colin Schieman, MD.

Colin Schieman, MD

Colin Schieman, MD

This focus on the high performers, rather than the low performers, is a change from how we typically think of morbidity data review, and it helps drive more open discussion and team-based improvement, said Dr. Schieman, of the University of Calgary in Alberta, Canada. Dr. Seely will show how this method, widely adopted by Canadian centers, objectively allows for implementing a quality improvement system.

“Most surgeons are uncomfortable with data collection,” Dr. Schieman said. “I was always worried about who would handle the data. What’s the intention going to be? How public would it be? Would there be any control for the complexity of the cases?”

With positive deviance, the data collection is anonymous with a focus on “like individuals in a group who are particularly good at certain areas,” Dr. Schieman said. “It’s a different way of framing the conversation.”

Susan D. Moffatt-Bruce, MD, PhD, MBA, of The University of Texas MD Anderson Cancer Center in Houston, will discuss how data derived from cardiothoracic surgery quality improvement efforts can lead to changes in care on a national scale.

“Her work is important because the whole process is about improving patient care,” Dr. Schieman said. “She’ll bring the discussion back to the patient and how to enhance patient safety. Instead of identifying where the problems are, she will close the loop, going from data generation, to review, optimizing the patient experience, and creating a mechanism for improving patient safety.”

STS Past President David A. Fullerton, MD, of the University of Colorado Anschutz Medical Campus, will then take the next step by looking at how public reporting of quality metrics can affect and improve cardiothoracic surgical practices.

“The data collected from hospitals, health administrators, regions, and societies provide powerful tools for surgeons to improve their performance, garner more resources for their institutions, and elevate the standard for all surgeons,” Dr. Schieman said. “Participation in our national databases is a major plus. Those who use the data can reflect on their own practices, but also on their own hospitals, cities, and regions to see where there are potential areas for improvement. This goes beyond individual surgeon performance.”

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