Ethical, legal, and health policy challenges in contemporary cardiothoracic surgeryCardiac Surgeons and the Quality Movement: the Michigan Experience
Section snippets
Historical Introduction
The Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS) was founded in 1965 during an era when many national, regional, and state speciality societies were beginning. The first meeting of what was initially called the Michigan Society of Thoracic Surgeons was held on September 21, 1965 in Detroit in conjunction with the Michigan State Medical Society (personal communication, Allen Silbergleit, MD, PhD, Historian, Michigan Society of Thoracic and Cardiovascular Surgeons, August
Partnering with a Payer
In 1996, the Blue Cross/Blue Shield of Michigan Centers of Excellence Project asked Michigan hospitals involved with interventional cardiologic approaches to coronary artery disease to consider participating in a voluntary registry. Nine hospitals agreed and a data registry of interventional procedures and outcomes was initiated in December 1997 known as the Blue Cross/Blue Shield of Michigan Cardiovascular Consortium (BMC2).1 This voluntary consortium involved physicians, administrators, and
Quality Collaborative
Prior to creation of the cooperative agreement with Blue Cross/Blue Shield of Michigan, all adult cardiac surgical sites in Michigan began participating in the MSTCVS quality collaborative. With the agreement, funding was provided to each site for a portion of the data manager's salary and the STS data submission fee and the STS-DCRI quarterly Michigan data reports. With additional budgetary monies, two experienced nurses were hired full time, one as the MSTCVS quality initiative specialist and
Improvement Initiatives
The initial phases of our State Society's quality initiative, even before partial payer funding, targeted process and outcome variables for focused review. These included the following:
- 1
Internal mammary artery (IMA) usage
- 2
Preoperative intra aorta balloon pump usage
- 3
Prolonged ventilation
- 4
Postoperative atrial fibrillation
- 5
Coronary artery bypass crude and risk adjusted mortality
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Partnering with payers to improve surgical quality: The Michigan plan
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A regional prospective study of in-hospital mortality associated with coronary artery bypass grafting
J Am Med Assoc
(1991) - et al.
Development of a multicenter interventional cardiology database: The Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) experience
J Interv Cardiol
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