Initiatives

Facility and Regional Reports

Facility and regional reports were produced and shared semi-annually among participating CWG members. Cardiac Registry analyses are framed in terms of improvement opportunities. Rather than a "report card" of good and bad results, regional and facility reports provided relevant information that can be applied to clinical practice. Findings were treated as working hypotheses and not final conclusions. The goal is to refine practice and increase the likelihood of improved patient outcomes.

Regional reports provided comparisons among different patient groups, clinical practices, and patients across facilities, while facility-level reports compared each facility on those components to all others in the region. However, since patients are not assigned at random to any particular treatment approach, such comparisons can be misleading if inherent differences in presenting patient characteristics are not taken into account. It is for this reason that development of "risk scores" and the use of "risk adjustment" was of critical importance to the Registry analyses. Risk models specific to the region revealed variation among facilities on all measures, suggesting opportunities for information sharing and regional improvement.

Beyond analyzing Cardiac Registry variables and reporting results, PRHI researchers actively participated in the change processes by providing clinicians with relevant and understandable information, monitoring outcomes, and by maintaining a salient research agenda that reflects current issues and practice. This collaborative approach increased the likelihood of information utilization and effective implementation of clinical process changes.

Confidentiality

As working papers, facility and regional reports are not open to the public and are meant to support continuous improvement through comparison and analysis of the data.

Members submitted blinded case data under facility numbers and PRHI is bound by contract not to disclose the identity of facilities or their related performance. Similarly, all CWG members are also bound not to disclose or use the CWG data outside of improvement discussions. This bars any use of the data for the purposes of marketing, business development planning, or gaining other commercial advantage.