Cardiac Registry
The Cardiac Working Group (CWG) began with a focus on coronary artery bypass graft surgery (CABG). In 2000, the CWG used Pennsylvania Health Care Cost Containment Council data to discover that their CABG readmission rate was twice as high (17%) as previously thought, and that post-operative infection was the leading cause of readmission.
In exploring how to measure and improve care processes and patient outcomes, the CWG created the Cardiac Registry, which tracked over 90 process and outcome variables on CABG surgeries.
Data on over 13,000 cases from ten of the region's 13 cardiac surgery units allowed the CWG to track regional and individual facility performance, identify best practices and conduct individual queries to support process improvement.
The Cardiac Registry captured five types of information:
- Demographics
- Risk Factors or Comorbidities
- Severity of Cardiac Status
- Processes of Care
- Patient Outcomes
The CWG adheres to a "data-driven improvement" philosophy. Providers and clinicians voluntarily submitted clinical data to the PRHI Cardiac Registry for analysis, not only to expose problems, but also to encourage reflection and further development among regional peers. Clinicians recognize problems, learn from them, and initiate practice changes. The Initiative created a safe environment for openly detecting and solving problems.
In this way, the Cardiac Registry created an opportunity for surgeons to hold one another accountable to apply best practices. In 2005, for example, cardiac surgeons from competing institutions met for the first annual regional morbidity and mortality conference. They discussed every regional death from cardiac surgery that occurred in the prior year in order to learn from each occurrence.