The Maryland Cardiac Surgery Quality Initiative is now in its tenth year and continues to advance the quality of cardiac surgery and reduce cost of care in the State of Maryland. Major accomplishments during this time include:
● Clinical Performance Improvements – As a state, key improvements between 2012 and 2022 include:
● Best Practice Guidelines – Through data analysis, practice assessments, literature review, and focused discussions, MCSQI Tenets were developed for: Early Extubation, Wound Healing, Readmission Reduction, Blood Management, and STS Data Management.
● Education and Communication – Over thirty-five educational presentations, webinars, workshops, and individual hospital meetings have been conducted in the past ten years. Performance Dashboards and individual hospital letters comparing STS Performance on a semi-annual basis were created to assist programs in identifying opportunities for improvement.
● Policy Recommendations – Over the years we have made formal recommendations to the Maryland Healthcare Commission (MHCC) regarding COMAR 10.24.17, the Health Service Cost Review Commission (HSCRC), and the Maryland Hospital Association (MHA) that have contributed to ensuring appropriate regulations and financial reimbursement. For example, the consensus statement submitted to MHCC and MHA resulted in the exclusion of four Potentially Preventable Complications (PPC) for cardiac surgical APR-DRGs.
● Collaboration – Formal relationships have been established with MHCC and HSCRC to link administrative and clinical data. Currently, four specific projects focused on resource utilization, cost variability, and clinical outcomes are in development. MCSQI also partners with other cardiac surgery collaboratives from around the country. All collaborative efforts have the common goal of enhancing the quality and value of patient care.
● Quality Research and Publications – Results include over 40 MCSQI research posters, manuscripts, and presentations at national societal meetings such as the Society of Thoracic Surgery and the American Association of Thoracic Surgery. Manuscripts have been published in the Annals of Thoracic of Thoracic Surgery, Journal of Thoracic and Cardiovascular Surgery, Journal of Hospital Administration, Journal of Cardiothoracic and Vascular Anesthesia, and others.
The organization remains steadfast to fulfill our mission to continuously improve the clinical quality of cardiac surgery in the state of Maryland through data analysis, research, and education. In 2022 MCSQI continued commitment to the advancement of Strategic Quality Initiatives:
o Readmission Reduction
o Understanding Postoperative Atrial Fibrillation V ariability o Cost Analysis and Improving V alue
o Blood Management Improvement
o Perfusion Variables and Reporting
o Deep Sternal Wound Healing
This report highlights progress made over the past ten years with these initiatives and others through collaboration among key stakeholders and a firm commitment to our mission.
Please share this report with your team and I hope you benefit from the information provided.
Niv Ad, MD