title: Establishing and using a local/regional cardiac surgery database.
abstract: BACKGROUND
  In 1993, the Minnesota Society of Thoracic Surgeons and the Minnesota Cardiac Surgery Database were organized in response to a third-party payer demand for data about practice protocols and patient outcomes. It has matured to an active organization of 46 cardiothoracic surgeons, 14 institutions, and more than 7,000 patients who have undergone coronary artery bypass grafting.
  
  
  METHODS
  Data are validated for completeness and accuracy through a statewide auditing process. They are coded by hospital, analyzed using the standard Society of Thoracic Surgeons National Cardiac Surgery Database format and definitions, and reviewed quarterly in a continuous quality improvement process.
  
  
  RESULTS
  Through data review and exchange site visits, variations in practice protocols and outcomes have been identified. For example, our statewide data review and continuous quality improvement process identified prolonged ventilation (more than 24 hours) as one variation. Multidisciplinary teams were defined, and statewide exchange site visits led by cardiovascular surgeons were implemented. An example of the improvement in the accuracy and completeness of the data used to study procedure outcomes is represented by the improved reporting of ejection fraction values that has resulted from this process.
  
  
  CONCLUSIONS
  Using the standardized Society of Thoracic Surgeons National Cardiac Surgery Database and the Minnesota Society of Thoracic Surgeons organizational structure to establish a high-quality database will allow for statewide peer review, exchange of practice guidelines, and promotion of standardization, which eventually can improve outcomes and reduce costs. This organization or model can be replicated at any local, state, or regional level. Thoracic surgeons faced with similar challenges for public disclosure of surgical results can learn much from the successful development of the Minnesota Cardiac Surgery Database.
authors.affiliation: Minnesota Society of Thoracic Surgeons, Minneapolis 55407, USA.
authors.forename: K V
authors.initials: KV
authors.lastname: Arom
authors.forename: R J
authors.initials: RJ
authors.lastname: Petersen
authors.forename: T A
authors.initials: TA
authors.lastname: Orszulak
authors.forename: R M
authors.initials: RM
authors.lastname: Bolman
authors.forename: P H
authors.initials: PH
authors.lastname: Wickstrom
authors.forename: L D
authors.initials: LD
authors.lastname: Joyce
authors.forename: T H
authors.initials: TH
authors.lastname: Spooner
authors.forename: B L
authors.initials: BL
authors.lastname: Tell
authors.forename: P A
authors.initials: PA
authors.lastname: Janey
mesh_terms: D002985:Clinical Protocols; D001026:Coronary Artery Bypass; D003625:Data Collection; D016208:Databases, Factual; D006801:Humans; D008910:Minnesota; D010380:Peer Review; D012955:Societies, Medical; D013903:Thoracic Surgery; D017749:Total Quality Management; D016896:Treatment Outcome