ArticleJTCVS open2025
A real-time rapid cycle process improvement tool for accelerated quality improvement in coronary artery bypass grafting surgery.
Article in JTCVS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- A Predictive Tool Using The Society of Thoracic Surgeons Risk Calculator for Safe Operating Room Extubation After Coronary Bypass Surgery.Annals of thoracic surgery short reports · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: We report a custom-designed visual feedback tool integrated into a comprehensive quality improvement (QI) program to drive accelerated, real-time advances in coronary artery bypass grafting (CABG) surgery. Methods: The Society of Thoracic Surgeons (STS) risk profiles of 977 consecutive patients who underwent CABG between January 1, 2021, and December 31, 2024 risk profiles were analyzed. For 2021-2022, the mortality observed-to-expected ratio (O/E) was 2.5. In 2023, we started a real-time, rapid cycle process improvement program. We designed a QI tool to calculate in real time the O/Es for death, stroke, renal failure, prolonged ventilation, reoperation, deep sternal wound infection, prolonged length of stay, and failure of left internal mammary artery (LIMA) use or medication compliance. We developed a final composite score in which we assigned 80% to mortality, 7% to LIMA use, 3% to medications, and 10% to nonfatal STS adverse outcomes as a rough estimate of the STS 3-star CABG construct. For a final composite grade, we assigned "good" (O/E < 0.65), "fair" (O/E = 0.65-1.0), or "poor" (O/E > 1.0) for each adverse outcome. Results: The CABG mortality O/E improved from 1.5 in 2021-2022 to 0.25 in 2023-2024 ( Conclusions: Our custom-designed QI tool enabled rapid improvement of our CABG outcomes (
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