Outcomes analysis in cardiac surgery

Abstract

From early age, we are taught to break apart problems, to fragment the world. This apparently makes complex tasks and subjects more manageable, but we pay a hidden enormous price. We can no longer see the consequence of our actions; we lose our intrinsic connection to a larger whole.¹

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References

Senge PM. The fifth discipline. The art and practice of the learning organization. Currency & Doubleday New York , 1994: 1-1.

Hammermeister KE , Shroyer AL , Sethi GK et al. Why it is important to demonstrate linkages between outcomes of care and processes and structures of care . Med Care 1995; 33: OS5-OS16 .

US Department of Health and Human Services . Medicare hospital mortality information. DHHS Publication 01-002. Washington, DC: US Department of Health and Human Services , 1987.

Dubois RW , Rodgers WH , Moxley JH III et al.

Hospital inpatient mortality: is it a predictor of quality?

N Engl J Med 1987; 317: 1674-1680 .

Green J , Winfield N , Sharkey P et al. The importance of severity of illness in assessing hospital mortality . J Am Med Assoc 1990; 263: 241-246 .

O’Connor GT , Plume SK , Olmstead EM et al. A regional prospective study of in-hospital mortality associated with coronary bypass grafting . J Am Med Assoc 1991; 266: 803-809 .

Shroyer AL , London MJ , Grover FL et al. The processes, structures, and outcomes of care in cardiac surgery study: an overview . Med Care 1995; 33: OS1-OS4 .

American Medical Association . American Medical Association report: the Council on Medical Services . J Am Med Assoc 1986; 18: 356-362 .

Donabedian A. Role of outcomes in quality assessment and assurance . Qual Rev Bull 1992; 18: 356-362 .

10.

Tobler HG , Sethi GK , Grover FL et al. Variations in processes and structures of cardiac surgery practice . Med Care 1995; 33: OS43-OS58 .

11.

Stewart AL , Hays RD , Ware J. The MOS short-form general health survey . Med Care 1988; 26: 724-724 .

12.

Kaspar JF , Plume SK , O’Connor GT. A method for QI in the coronary artery bypass grafting procedure involving comparative process analysis . Qual Rev Bull 1992; 18: 129-133 .

13.

O’Connor GT , Plume SK , Olmstead EM et al. Multivariate prediction of in-hospital mortality associated with coronary artery bypass graft surgery . Circulation 1992; 85: 2110-2118 .

14.

O’Connor GT , Plume SK , Olmstead EM et al. A regional intervention to improve the hospital mortality associated with coronary artery bypass graft surgery . J Am Med Assoc 1996; 275: 841-846 .

15.

Walton M. The Deming management method. New York: Dodd Mead , 1986.

16.

Berwick DM. Continuous quality improvement as an ideal in health care . N Engl J Med 1989; 320: 53-56 .

17.

Batalden PB , Nelson EC , Robert JS. Linking outcomes measurement to continual improvement: the serial ‘V’ way of thinking about improving clinical care . J Qual Improve 1994; 20: 167-180 .

18.

O’Connor GT , Plume SK , Wennberg J. Regional organization for outcomes research . Ann NY Acad Sci 1993; 703: 44-51 .