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Coronary Artery Bypass Graft Surgery

What is Coronary Artery Bypass Graft Surgery?  Coronary Artery Bypass Graft Surgery, sometimes called CABG, is a type of heart surgery.  During the surgery, a segment of a healthy blood vessel from another part of the body is used to make a detour around the blocked part of the coronary artery.  This “bypass” around the clogged artery improves flow which helps to restore oxygen delivery to the heart.

 

 

 

CABG surgery has been available at Baystate Medical Center since 1978 and approximately 800 cases are performed annually.  The Division of Cardiac Surgery (DCS) and the Division of Healthcare Quality (DHQ) continually measure and improve clinical, quality of life, and patient satisfaction outcomes.  To help compare quality and identify process improvements, the DCS participates in the Society of Thoracic Surgeons (STS) comparative database and the Surgical Care Improvement Project (SCIP), co-sponsored by the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control (CDC).  STS provides risk-adjusted information on observed and expected complications to focus improvement efforts, as well as provides CABG mortality, complications, and efficiency by surgeon.  This data is publicly reported on the Commonwealth of Massachusetts Health Care Quality and Cost Information site (mass.gov/healthcareqc); BMC has consistently had the lowest mortality in the state.

 

SCIP encourages hospitals to incorporate interventions known to decrease adverse surgical events.  Intervention compliance rates along with other key processes of care provide the basis for physician-specific feedback, which enables the surgeons to compare their individual performance with those of their colleagues. 

 

Many interventions have focused on improving OR efficiency (consistent dedicated start times), appropriate use of new technologies, such as minimally invasive procedures and anesthetic agents, continued early extubation (RT/RN driven protocol in CICU), prevention of ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSIs), multidisciplinary care rounds, proactive planning, and timely triage of patients through the hospitalization. 

 

Highlights

 

Baystate Medical Center 

  • BMC continues to provide exceptional care for patients undergoing Coronary Artery Bypass Surgery.
    • Appropriate antibiotic selection is 100%.
    • Administration of antibiotics within 60 minutes prior to incision is 100%.
    • Antibiotic discontinued within 24 hours is 100%. 
    • Appropriate hair removal is 100%.
  • For the past 13 years our risk-adjusted mortality rates have remained lower than expected, with no CABG deaths in the past 4 quarters.  However, our rate increased slightly this current quarter.

 

These rates, combined with low rates of infection, post-operative hemorrhage and hematoma, and adoption of minimally invasive and robotic procedures, have made BMC a national leader, consistently performing in the top 10th percentile of HQI hospitals.

 

 

For more information on Quality at Baystate Health

For more information on Baystate Medical Center

For more information on Baystate’s Heart and Vascular Program

For more information on the Baystate Health Division of Healthcare Quality

For more information on the Society of Thoracic Surgeons