Monitoring cardiac surgical performance and patient outcomes - the ANZSCTS Database Program

Purpose: The Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) Database Program is an established quality assurance program aimed to monitor and improve cardiac surgical performance. The program collects routine systematic data related to all cardiac surgical procedures and monitors that data as a means to review surgical unit outcomes. Methodology: Participating hospitals are responsible for accurate data collection, and electronic submission, of over 300 variables capturing pre-, intra-, and post-operative cardiac surgery outcomes. Data and project management, including collection, analysis, and reporting is conducted by the Centre for Cardiovascular Research and Education in Therapeutics (CCRET), Monash University. Results: Currently 23/24 public and 8/33 private hospitals participate in the program. Over 100,000 procedures have been collected of which 55% are isolated CABG. Thirty day mortality rate for isolated CABG, isolated AVR and other cardiac procedures is 1.6%, 2.8% and 6.1% respectively. Quarterly, data cleaning to ensure quality is performed, and key performance indicators are reported. An escalation plan is in place for outlying indicators, where the Program collaborates with the appropriate contributors to deploy strategies to meet national standards. An annual report showcases national performance and patient outcomes; all participating hospitals deliver a high standard of care, comparable to hospitals in equivalent countries. Conclusions: The ANZSCTS Database Program provides a platform to benchmark hospital performance and patient outcomes. We hope to achieve 90% population coverage with the goal of standardising a high level of cardiac surgery care and improved patient outcomes. Words: 250; 244 Key words: Surveillance/registries; epidemiology Key messages: 1. Clinical registries are essential in capturing data to monitor practice and outcomes. 2. Feedback reporting and escalation plans ensure high level outcomes. 3. All units should participate to ensure valid, high quality data is reported.

Christopher Reid & Nupur Nag

Curtin University/Monash University

Professor Christopher Reid is the Director of the Monash Centre of Cardiovascular Research and Education in Therapeutics and the NHMRC Centre of Research Excellence in Cardiovascular Outcomes Improvement (2016-2020). His major research interests include clinical outcome registries, randomised controlled trials, and epidemiological cohort studies.

Dr Nupur Nag is the Program Manager of the ANZSCTS Database Program (HTTP://ANZSCTS-DATABASE.ORG/). Her research interests include epigenetics, patient reported outcome measures, and cardiovascular health.