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

The Journal of Thoracic and Cardiovascular Surgery
Jason P GlotzbachCraig H Selzman

Abstract

The objective of this study was to determine if the implementation of a value-driven outcomes tool comprising modifiable quality and utilization metrics lowers cost and improves value of coronary artery bypass grafting (CABG) postoperative care. Ten metrics were defined for CABG patients in 2 temporally separated phases. Clinical care protocols were designed and implemented to increase compliance with these metrics. Clinical outcomes and cost data were harvested from the electronic medical record using a proprietary value-driven outcomes tool and verified by a data management team. "Perfect care" was defined as achieving all 10 metrics per patient episode. Over a 45-month period, data of 467 consecutive patients who underwent isolated CABG were analyzed. "Perfect care" was successfully achieved in 304 patients (65.1%). There were no observed differences in mortality between patient groups. Linear regression analysis showed a negative correlation between percent compliance with "perfect care" and mean cost. When multivariate analysis was used to adjust for preoperative risk score, mean cost for patients with "perfect care" was 37.0% less than for those without "perfect care." In the context of focused institution-specific interv...Continue Reading

Citations

Nov 13, 2020·Circulation. Cardiovascular Quality and Outcomes·Alexander A BresciaUNKNOWN Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC) and the Michigan Value Collaborat
May 5, 2021·Texas Heart Institute Journal·Vikas SharmaCraig H Selzman
Jul 1, 2021·Journal of Healthcare Management / American College of Healthcare Executives·Bruna Stella ZanottoCarisi Anne Polanczyk

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