Cardiac surgery benchmarking: A quality improvement initiative

Background: Benchmarking programs help in reviewing and validating clinical practice and improves quality of care Methodology: Fifteen accredited hospitals participated in International cardiac surgery benchmarking (ICSB) project from eight different countries including ours, Aga Khan University Hospital, a "clinical data coordinator" was trained to facilitate data collection, verification and eventual submission. The data was collected prospectively for preoperative characteristics, intraoperative variables and postoperative outcomes. Onsite data validation was also performed by a JCI representative for the accuracy of data. Data analyzed and reported on six quarters starting from October, 2009 to March, 2011. Results: A total of 4761 isolated CABG including 474 from our hospital entered Into ICSB. The postoperative complication rate for ICSB and our hospital were calculated showing a higher rate of reopening (2.5 vs. 1.7%), higher postop renal dysfunction (5% vs. 1%) and a higher RBC transfusion (6lvs 36%) but the incidence of stroke, myocardial infarction and deep sternal wound infection were low at our hospital. Risk factors that predict surgical death for CABG in this model arc very similar to those used in New York state hospitals. The overall risk adjusted 30-day mortality was 3-4% at our hospital compared to 1.9% for ICSB. Conclusion: By benchmarking program our practice and data collection methodology has been reviewed and validated. Feedback will serve as regulatory function leading towards self-Assessments to improve quality of care.