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3 surgery groups win top rating

By Dave Gulliver
9/8/2010 © Health News Florida

Three Florida heart surgery groups received the top rating in the first-ever publication of quality assessments for bypass surgery nationwide -- “a watershed event in health care accountability,” The New England Journal of Medicine said.

The three-star groups listed for Florida are:

  • Cardiovascular Surgical Associates, Tampa, affiliated with St. Joseph’s Hospital 
  • Munroe Heart, Ocala, affiliated with Munroe Regional Medical Center
  • Bostick Heart Center, Winter Haven, affiliated with Winter Haven Hospital

The results, available to subscribers of Consumer Reports at its website, are from an outcomes registry maintained by the Society of Thoracic Surgeons since 1989. More than 1,000 surgical groups -- representing some 3,000 surgeons and 90 percent of the field -- participated.

While the New England Journal praised the surgery group for establishing a landmark in transparency, they also noted the survey’s initial weaknesses.

Only 221 heart surgery groups that are part of the registry volunteered to participate in the Consumer Reports project. Of them, 50 had the top three-star rating, while only five rated one-star -- a sign that the best programs are using the study to promote themselves, while the poor performers are staying in the shadows.

But the journal authors say publication is an important first step that will lead to better information.

“Nonparticipating cardiac surgery programs will come under pressure to allow the outcomes in their programs to be reported,” they wrote.

“Physicians in other surgical specialties that are amenable to this type of approach, such as orthopedics or vascular surgery, may be expected to follow suit.”

The study looked only at coronary artery bypass grafts, or CABG, in isolation. To maintain an apples-to-apples comparison, the study excluded cases where CABG was done with other procedures.

The Society of Thoracic Surgeons developed its ratings from measures developed by the National Quality Forum, a non-profit consortium of hospitals, doctors, nurses, quality experts and other healthcare groups.

They are based on the percentage of patients who had survived 30 days after hospital discharge; avoided the five major complications; received an internal mammary artery graft, considered a best surgical practice; and received four types of recommended medications (beta blockers before surgery, and aspirin, beta blockers and lipid-lowering therapy after surgery).

The other Florida practices reporting results all received a rating of two stars, or average results:

--Memorial Healthcare System Cardiac and Vascular Institute, Hollywood, affiliated with Memorial Regional Hospital, two stars

--Sarasota Memorial Healthcare System, Sarasota, two stars

--University of Florida College of Medicine, Division of Cardiothoracic Surgery, Jacksonville, affiliated with Shands Jacksonville Medical Center.

--Dave Gulliver is an independent journalist in Sarasota. Questions or comments can be addressed to Carol Gentry, Editor.