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Quality Improvement in Cardiac Care
Frederick L. Grover, MD;
Joseph C. Cleveland, Jr, MD;
Laurie W. Shroyer, PhD
Arch Surg. 2002;137:28-36.
Quality improvement in cardiac care has made considerable progress over the past 30 years. During that period, there has been the development of multi-institutional databases to monitor outcomes following cardiothoracic surgery. These databases initially began using only volume and unadjusted operative (30-day) mortality as outcome criteria. There has been a progressive increase in their sophistication, with the building of risk models based on preoperative variables, which accurately predict the risk of adverse outcomes. Other outcomes have been added including risk-adjusted mortality and morbidity; efficiency outcomes such as length of stay, quality of life, functional health status, neuropsychological outcomes; and long-term outcomes.
From the Division of Cardiothoracic Surgery (Drs Grover and Cleveland) and the Department of Medicine (Dr Shroyer), University of Colorado Health Science Center; and the Denver Veterans Affairs Medical Center (Drs Grover, Cleveland, and Shroyer), Denver, Colo.
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