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Ibrahim M, Szeto WY, Gutsche J, Weiss S, Bavaria J, Ottemiller S, Williams M, Gallagher JF, Fishman N, Cunningham R, Brady L, Brennan PJ, Acker M. Transparency, Public Reporting and a Culture of Change to Quality and Safety in Cardiac Surgery. Ann Thorac Surg 2021; 114:626-635. [PMID: 34843698 DOI: 10.1016/j.athoracsur.2021.08.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022]
Abstract
Academic medical centers have a duty to serve as hospitals of last resort for advanced cardiac surgical care and therefore manage patients at elevated risk of post-operative morbidity and mortality. They must also meet state and professional quality targets devised to protect the public. The tension between these imperatives can be managed by a multi-dimensional quality improvement program which aims to manage risk, optimize outcomes and exclude futile operations. We here share our approach to this process, its impact on our institution and discuss pertinent issues relevant to institutions in a similar situation.
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Affiliation(s)
- Michael Ibrahim
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Wilson Y Szeto
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacob Gutsche
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Steve Weiss
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph Bavaria
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stephanie Ottemiller
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Matthew Williams
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jo Fante Gallagher
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Neil Fishman
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Regina Cunningham
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Luann Brady
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Patrick J Brennan
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael Acker
- Division of Cardiovascular Surgery, Penn Cardiovascular Institute, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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