National Cardiovascular Surgery Quality Improvement Network Planning Conferences

描述（由申请人提供）：在美国，每年有超过50万的患者接受心脏直视手术，以延长他们的生命或缓解冠状动脉或瓣膜性心脏病的症状。已经出现了几个心脏外科质量改进合作组织，其重点是利用来自区域和国家登记处的数据来衡量、组织和改进心胸外科护理。这些合作组织将其活动重点放在若干领域，包括：临床决策（开发和实施风险预测模型）、观察流行病学（确定临床护理的变化及其后果）、质量改进（确定与改善结果有统计学联系的“上游”过程措施）和公开报告（绩效措施的透明度）。虽然共享任务在概念上将这些临床合作联系在一起，但这些群体之间从未有过交叉受精的机会。区域心胸外科合作网络的发展[在此称为改进（IMPROVE）网络]将为利用每个合作的优势提供机会，无论是成本控制，风险调整，研究设计，付款人的参与，还是支持质量改进团队，以提高整个改进网络的心脏外科护理的安全性和价值。必须解决若干问题（与结构、功能、数据所有权、通信和资金筹措有关），以促进改善网络的发展。确定一系列障碍以及解决办法将成为两个规划会议的重点，以发展一种新的结构，以发展新的研究调查路线和进行质量改进研究。在当前提案期间，我们设法召集每个合作组织的代表两次。在第一次会议期间，我们将确定现有合作伙伴之间重叠的方面，并以白皮书的形式为拟议的改进网络奠定基础（使命、愿景、结构和融资）。在首次会议之后，每个合作组织将分发白皮书并征求其成员的意见，为第二次会议做准备。在第二次会议期间，与会者将批准建立改进网络，并为提交给AHRQ的R01开发内容，这将利用通过该网络的发展获得的基础设施。

DESCRIPTION (provided by applicant): More than a half million patients undergo open-heart surgical procedures annually in the United States to extend their life or relieve symptoms from their coronary or valvular heart disease. Several cardiac surgical quality improvement collaboratives have emerged whose focus has been to leverage data derived from regional and national registries to measure, organize and improve cardiothoracic surgical care. These collaboratives have focused their activities in a number of areas, including: clinical decision-making (development and implementation of risk prediction models), observational epidemiology (identifying variation in clinical care and its consequences), quality improvement (identification of "upstream" process measures statistically linked to improved outcomes), and public reporting (transparency of performance measures). While shared missions conceptually link these clinical collaboratives, there has never been an opportunity for cross-fertilization between these groups. The development of a network of regional cardiothoracic surgical collaboratives [herein called the IMPROVEment (IMPROVE) Network] would provide opportunities for leveraging each collaborative's strengths, whether cost containment, risk adjustment, study design, engagement of payers, or supporting quality improvement teams, to improve the safety and value of cardiac surgical care across the IMPROVE Network. A number of issues (related to structure, function, data ownership, communication and financing) must be addressed to facilitate the development of the IMPROVE Network. Identifying the set of obstacles as well as solutions will form the focus of two planning conferences to develop a novel structure for developing new lines of research inquiry and conducting quality improvement studies. We seek to convene representatives from each collaborative twice during the current proposal. During the first session, we will identify aspects of overlap across existing collaboratives and develop the foundation (mission, vision, structure and financing) for the proposed IMPROVE Network in the form of a white paper. Subsequent to this inaugural meeting, each collaborative will distribute and seek comments from its membership on the white paper in preparation for the second conference. During the second conference, attendees will endorse the formation of the IMPROVE Network and develop the content for an R01 submission to AHRQ that would leverage the infrastructure gained through the development of this network. PUBLIC HEALTH RELEVANCE: More than a half million patients undergo open-heart surgical procedures annually in the United States to extend their life or relieve symptoms from their coronary or valvular heart disease. Several regional cardiac surgical quality improvement collaboratives have emerged to improve the quality of cardiac surgical care provided within their respective regions. The focus of this small conference project will be to establish a network for linking these collaboratives together to (1) develop and implement research and quality improvement projects, and (2) improve the safety and value of cardiac surgical care across their respective regions.