Regional Organization for Outcomes Research

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Abstract
Methods for achieving improvement in medical and surgical outcomes are often discussed, but rarely achieved. We report on a regional voluntary consortium founded in 1987 to provide information about the management of cardiovascular disease in northern New England. Members include all cardiothoracic surgeons and interventional cardiologists in the region, as well as administrators and scientists associated with the five institutions that provide advanced cardiac services in this region. The group maintains registries for coronary artery bypass grafting, coronary angioplasty, and heart valve surgery and has investigated institutional differences in mortality rates; the development and use of clinical prediction rules; the reasons for excess mortality among women undergoing bypass graft surgery; and time trends in the use of myocardial revascularization. This consortium is an inter-institutional model for the continuous improvement of medical and surgical care.