In 2012, the Department of Cardiac Surgery created the Section of Health Services Research and Quality (HSRQ). Under the leadership of Dr. Donald Likosky, this Section contributes to an understanding of current healthcare delivery systems and evaluates targeted changes to improve their overall quality and efficiency. Areas of interest include the determinants and implications of variation in the surgical treatment of heart disease, the evaluation of traditional and novel therapies, the evaluation of current health policies on the healthcare delivery system, and the development and implementation of best practices.
Dr. Likosky’s work has created new insight into the patterns and consequences of care and reduction in unwarranted variation in practices, primarily within the context of regional and national quality improvement organizations. Under grants through the Agency for Healthcare Research and Quality, Dr. Likosky has partnered with surgeons from the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative to evaluate determinants of variability in blood utilization, as well as post-operative, hospital acquired infections following Coronary Artery Bypass Grafting (CABG).
Under a separate grant from the Agency for Healthcare Research and Quality, Dr. Likosky created a network of regional cardiac surgical quality improvement collaboratives, the National Cardiac Surgery Quality IMPROVEment (IMPROVE) Network, which seeks to increase the value of cardiovascular surgical care by developing, evaluating and sharing best practice knowledge gained from quality improvement projects across the member organizations. In partnership with members from the clinical community, the team created a cardiovascular perfusion registry that links surgical data with data elements reflecting technology and processes of cardiovascular perfusion care. This registry, called Perfusion Measures and Outcome (PERForm), provides the foundation for participating centers to assess and improve the care and outcomes for patients undergoing cardiac surgery. The PERForm registry is now being used at cardiac surgical programs across the United States.
The Section of Health Services Research and Quality is used by faculty to discover new treatments for patients with acquired and congenital cardiovascular disease. Its rich data warehouse includes both clinical and administrative data and is linked to the National Death Index for the assessment of long-term survival. Clinical faculty receive contemporaneous benchmarking reports to facilitate the ongoing evaluation and targeted improvement in clinical outcomes. HSRQ has full-time data warehouse and biostatical support, and convenes monthly Research-in-Progress seminars to provide critical feedback on projects led by faculty or trainees. Faculty, in partnership with the Section of Health Services Research and Quality, continue to actively participate in the evaluation of current healthcare policies, and contribute to the development of more effective statewide and national policies aimed at improving the efficiency and reliability of cardiac surgical practices.
HSRQ continues to invest in the educational mission of the department. Medical students and surgical trainees have participated and/or led investigations leveraging the infrastructure created through the Section of Health Services Research and Quality.
Vision: The Section of Health Services Research and Quality will be the preeminent academic research team in the field of cardiac surgery.
Mission: The Section of Health Services Research and Quality will make substantial contributions to the understanding and quality of cardiac surgery for patients of all ages through strategic and effective collaboration among research scientists and clinicians. We will achieve this mission by:
- Creating new, generalizable knowledge through peer-reviewed publications and presentations,
- Evaluating the effectiveness of current delivery models, and influencing policy experts to improve our health care system performance
- Innovating the delivery of care through the engagement of patients, their families, and frontline clinical providers,
- Providing training and support to the next generation of students, physicians and research scientists in the fields of health care evaluation and improvement