At its annual meeting on June 28, 2014 CASTS board members and representatives from the data managers group discussed changes that would allow STS/ACC data abstractors and their quality administrators access to CASTS membership. Scott Kronenberg agreed to prepare a bullet list of action items that would accomplish the mutual goals of surgical teams and hospital quality personnel. The CASTS urges everyone involved in data collection and quality management to be involved in the discussion. Please review the proposal prepared by Scott and post your comments here!
James MacMillan attended a hearing in Sacramento last week at which Senate Bill 830 was presented and discussed. Dr. MacMillan submitted a letter of support and made a presentation to the committee hearing. He described the changes that have occurred in cardiovascular procedures since the beginning of public reporting of CABG more than ten years ago. The incidence of CABG has decreased, and there are now 4 times more PCI’s than CABG procedures performed in California. Heart Valve procedures have increased relative to CABG, now representing more that half of the cardiac surgeres performed at most hospitals. Outcomes for CABG and valve surgery have improved, and recent data shows that PCI accounts for more deaths and complications than cardiac surgery. His presentation was well received and there appears to be little opposition to the expansion of public reporting.
The CASTS reporting website has been completely revised and updated. The California Cardiac Surgery and Intervention Project (CCSIP) collects data annually from the OSHPD Patient Discharge Database and reports hospital-specific outcomes on CABG, Valve, and PCI procedures. In-hospital and 90-day post hospital mortality and adverse events are reported. The current revision is intended to provide notice to California heart programs in advance to public reporting that will follow passage of SB 830. Cardiac surgeons and heart teams may gain access to the new data by registering at the CASTS login page. The reporting website is also linked from the CASTS home page.
CASTS board members had an informal luncheon meeting at the STS in Orlando. The primary topic of conversation was related to the update of the mandatory public reporting law SB 680. The update, known as SB 830, is in draft form and currently being prepared by James MacMillan of CASTS and Bill Bommer of CAACC. The legislation will allow reporting of PCI and Valve outcomes beginning in 2015. CASTS is also preparing an update to its reporting site www.californiacardiacsurgery.com which will provide an examples of information that may be presented in future public reports. The new reports are designed similar to those in New York, which provide aggregated isolated valve and valve-CABG groups as well as CABG and PCI. The reports will be available at the end of March to qualified users.
We had a very productive meeting today with Senator Galgiani and her chief of staff, Ross Warren. Nilas Young, Chief of Cardiac Surgery at Davis Medical School, Junaid Khan, President of CASTS, Bill Bommer, Professor of Cardiology at Davis, and James Macmillan were present. They have submitted a spot bill which is quite good, but needs some additions which they invited us to submit. We all agreed on the strategy of portraying this effort as an update to SB 680 to account for changes in practice patterns and new procedures, ie PCI reporting.
James MacMillan is planning a meeting with CA State Senator Cathleen Galgiani next month in Sacramento. She has agreed to sponsor the amendments to SB 680. We also have contacted Elizabeth (Betsy) Imholz, who is head of the west coast health team for the Consumers Union. Betsy was part of the group that sponsored the original bill in 2001. She indicated that the bill mandated OSHPD to report on all surgical and obstetrical procedures and that she was surprised that this hadn’t happened. CU will help with an update to make more reports available to the public. CASTS and CAACC will be soliciting ideas from members about the reporting process.
The CASTS Board of Directors met at the California ACC Awards Dinner in Beverly Hills on November 22. Discussion topics included physician-hospital affiliation structures, public reporting of PCI and valve procedures, and regional initiatives for data sharing. Dr. MacMillan reported that he has been in contact with Cathleen Galgiani, state senator from his district, who is interested in sponsoring legislation to update SB 680, the mandatory reporting law. Bill Bommer, immediate past president of CAACC, and Joe Parker, head of the Healthcare Outcomes Center at OSHPD, will also participate in the process. A meeting will be held in Sacramento in the near future.
Dr. Caffarelli will produce a report on the various options available for physician-hospital affiliation. Dr. Kamlot will report back about data sharing and quality improvement efforts with CA data managers. Minutes of the meeting are attached below.
Welcome to the California STS blog site. We hope this forum will be useful to data managers and heart team members. Please add your comments to this or any of the posts in other categories. We also would like you to register as a user, so that you can author your own posts. There are a number of issues of importance to data managers, for example. Is the STS database becoming too complicated? Are there too many version changes? Do the California data managers need their own organization or should they remain affiliated with the CASTS? What is the value of public reporting? Should other procedures (valve, PCI) be reported? Please add your voice to these and any other topics of importance to you–we value your opinions and ideas!