Professional Society Leadership in Health Care Quality: The Society of Thoracic Surgeons Experience.

UNLABELLED: In 1989 the Society of Thoracic Surgeons (STS) initiated the STS National Database, which subsequently became the cornerstone of a multifaceted STS quality program.

METHODS

The STS quality program is overseen by the STS Council on Quality, Research, and Patient Safety, which has four components. The Workforce on Research Development, in collaboration with the STS Research Center, coordinates clinical research based on the STS National Database, all of which is focused on improving clinical outcomes. The Workforce on Evidence Based Surgery develops clinical practice guidelines and expert consensus documents to foster the use of best practices. The Workforce on Patient Safety disseminates high-reliability practices from within and outside health care to improve the safety of cardiothoracic surgical care. The Workforce on National Databases consists of four subspecialty registries (adult cardiac, congenital cardiac, general thoracic, mechanical circulatory support [Intermacs and Pedimacs]) and multiple functionally oriented task forces (Quality Measurement, Quality Initiatives, Public Reporting, Informatics, Patient-Reported Outcomes, and Aortic Surgery).

RESULTS

Between 1998 and 2016, the rates of coronary artery bypass grafting surgery adverse outcomes decreased substantially, including operative mortality (-31.3%), renal failure (-56.3%), stroke (-43.5%), reoperation (-65.7%), and sternal infection (-50.0%). Comparable increases in process measure compliance included internal mammary artery use (32%), preoperative beta-blocker use (83.1%), discharge antiplatelet drugs (22.9%), discharge antilipid drugs (78.6%), and discharge beta-blockers (54.1%).

CONCLUSION

The STS quality program has achieved remarkable, continuing improvements in patient safety and quality over several decades. The components of this program can be replicated by other health care professional societies to advance quality and safety for their patient populations.