Data Managers and Heart Team Members

CASTS Reorganization to Include Data Managers/Quality Administrators

At its annual meeting on June 28, 2014 CASTS board members and representatives from the data managers group discussed changes that would allow STS/ACC data abstractors and their quality administrators access to CASTS membership. Scott Kronenberg agreed to prepare a bullet list of action items that would accomplish the mutual goals of surgical teams and hospital quality personnel. The CASTS urges everyone involved in data collection and quality management to be involved in the discussion. Please go to the CASTS blog to post your comments. If you are not registered, please click on the data managers login and do so.

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The CASTS would like to engage patients and other healthcare stakeholders, as well as physicians and cardiac team members, in the quality improvement process. Consistency and transparency in information sharing is critical to the process of communication across personal and professional boundaries. Input from all disciplines and individuals must be sought and valued.

The "heart team " concept has provided a platform to bring together cardiovascular specialists from various disciplines in the patient care process.  New procedures such as transcather aortic valve replacement have required the integration of surgeons and interventialists to make decisions concerning indications and approaches.  Guidelines for coronary interventions require concordant decision-making by cardiologists, surgeons and caregivers for patients with advanced disease. Establishing a dialogue, an action plan, and a QI agenda involving multiple heart programs, practices and heart team members will favorably impact standards of care.  Defining a model quality agenda for the state's cardiac surgical community is a CASTS priority.

The CASTS therefore would like to encourage all heart team members to participate in society activities--physician assistants, perfusionists, nurses, operating room staff, data managers and administrative personnel.  However, the process of accomplishing this laudable goal has not be easy or obvious.  Ed Fonner, before his recent resignation, proposed that data managers and other heart team members be offered full membership in CASTS, with privileges to become officers or directors of the corporation.  This proposal was not well received by CASTS physicians and directors, who felt that it was not consistent with the goals of CASTS as a society of surgeons.

In the aftermath of Ed Fonner's resignation, California Data Managers have proposed the formation of a new, all inclusive organization to pursue quality improvement goals.  The mission of this organization was described as follows by Jessica Coyne-Lowe of John Muir Health:

"The California Cardiothoracic Surgery Collaborative (CCSC) is organized to improve decisions affecting the cardiothoracic surgical community, to ensure fairness, accuracy, and completeness of publicly-reported healthcare information, to encourage adoption of evidence-based best practices, and to better manage patient outcomes data with training opportunities and peer-to-peer information exchange. Its objectives are to improve advocacy, enhance communications, pursue quality improvements, and support sound decision-making.

Our Goals:

1.            Collect, share, and analyze patient data concerning safety, quality of care, and process innovations in the cardiac surgery area to improve decision-making on quality and cost management issues;

2.            Create a collaborative infrastructure which can monitor and analyze outcomes, develop best practice care processes, and through process improvement enhance the quality of care in cardiac surgery;

3.            Facilitate communications and educational activities in the cardiac surgical community to ensure the integrity of publicly-reported healthcare information and address relevant issues facing the cardiac surgical community in California;

4.            Support education initiatives aimed at improving patient health literacy, informed patient choice, and medical decision-making."

With the exception of the emphasis on public reporting and collection of outcomes data, the described goals are consistent with the mission of the CASTS.  While it is true that the creation of the CASTS was influenced by the need to monitor pubic reporting initiatives and ensure the quality of outcomes data, the interests and goals of surgeons and heart team members go well beyond these areas.  In order to further collaboration and collegiality among heatlhcare professionals and stakeholders in cardiac and thoracic surgery, the CASTS would like to establish a dialogue to move the process of organizing heart team members in the correct direction.

So, please register at the Login link, and blog site.  Let us hear from you--add your voice to the discussion! 

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