Quality & outcomes in cardiac surgery

December 5, 2013 Glenn R. Barnhart

Do all cardiac surgery programs have the same quality outcomes? This is an important question all consumers must ask themselves if they or their loved ones must undergo an operation on their heart. Heart surgery has become increasingly common in recent years. Earlier awareness on the part of physicians and patients, advanced diagnostic testing and an increasing aging population with the inherent prevalence of heart disease has led to this surge in cases. Additionally, cardiac surgical teams are now operating on patients with multiple medical problems and doing more complex operations. Even with these factors, outcomes for patients continue to be optimal at centers of excellence.

But for today’s consumer, how does one choose where to have heart surgery? There are numerous choices both locally and nationally for all metropolitan areas. The consumer must ask: how do I know I am going to get the best of care? Should I go to a center with a “national” reputation? Is it just the doctor that makes the difference or does it involve the entire team caring for me: cardiologists, cardiac anesthesiologists,  physician assistants, ICU nursing and intensivists (doctors specialized in the care of the ICU patient), OR staff, etc.? All of these questions must be asked before considering such an important operation at any hospital by any surgical team.

One of the best yardsticks for outcomes to help patients choosing where to have their surgery is called the Adult Cardiac Surgery Database. This database was started in 1989 by the Society of Thoracic Surgery and has become a model for professional accountability when assessing a program’s outcomes in heart surgery. Since January of 2011 this database has been publicly reported. This database now represents patients at 998 centers (over 90% of all centers doing cardiac surgery) who have undergone heart surgery for various indications and allows centers around the country to evaluate their own outcomes and see where improvements can be made. Programs are rated on a 3 star system: 1 star means that the program is in the lowest 1-15 percentile, 2 star rating means that the program is in the middle16-84 percentile and a 3 star rating means that the program is in the highest quality 85-99 percentile of all 998 reporting centers in the country.

Recently, Swedish Medical Center received our report card from the above database. We are pleased to report that we are a 3 star program in Coronary Artery Bypass Surgery, Aortic Valve Replacement as well as simultaneous Aortic Valve Replacement and Coronary Artery Bypass Surgery. This places Swedish in a group of only 23 hospitals across the country to achieve these quality metrics. While we are pleased with these outcomes, we are continuing to make improvements in how we care for our patients so that every patient will get the best possible outcome. Click here to learn more about heart surgery at Swedish.

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