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Next Steps for COAP and the Bree Collaborative: Phase of Care Mortality Analysis (POCMA)

Next Steps for COAP and the Bree Collaborative: Phase of Care Mortality Analysis (POCMA) November 30 th , 2012 Chris Bryson, MD, MS – COAP Medical Director Kristin Sitcov – COAP Program Director . COAP Quality Improvement Efforts: Phase of Care Mortality Analysis (POCMA).

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Next Steps for COAP and the Bree Collaborative: Phase of Care Mortality Analysis (POCMA)

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  1. Next Steps for COAP and the Bree Collaborative: Phase of Care Mortality Analysis (POCMA) November 30th, 2012 Chris Bryson, MD, MS – COAP Medical Director Kristin Sitcov – COAP Program Director

  2. COAP Quality Improvement Efforts: Phase of Care Mortality Analysis (POCMA) • Developed by the Michigan Society of Thoracic & Cardiovascular Surgery Quality Collaborative (MSTCVS - 33 cardiac surgery programs) – Frank Shannon, MD & colleagues. • Surgeons & team members were shown how to identify the seminal event (death trigger) that initiated deterioration resulting in death. • The surgeon & team complete a POCMA form for every mortality. • Each death is reviewed by the “Mortality Outcomes Review Group” (MORG), consisting of 16 cardiac surgeons from around the state with specific interest in quality improvement. • POCMA data is linked with STS data to facilitate ad hoc analysis to correlate risk factors & clinical variables with the POCMA assessment. • A death is judged avoidable if >50% likelihood that optimal care or absence of the clinical event would have resulted in survival. • Implementation has resulted in 50% reduction in overall mortality (from 2% to 1%). • Provides a structured platform for discussion, education, quality improvement and improved outcomes

  3. COAP Quality Improvement Efforts: Phase of Care Mortality Analysis (POCMA) Shannon, FL, et al. Ann Thorac Surg. 2011.07.057 ARMUS

  4. COAP Quality Improvement Efforts: Phase of Care Mortality Analysis (POCMA) Shannon, FL, et al. Ann Thorac Surg. 2011.07.057 ARMUS

  5. Washington State POCMA Efforts: • May 2011 COAP Statewide Meeting – • Frank Shannon, MD, William Beaumont Hospital, Troy, Michigan • Overview of the Michigan experience with POCMA • May 2012 COAP Statewide Meeting – • Pat Ryan, MD, Providence Regional Medical Center, Everett • Eric Lehr, MD, Swedish Medical Center, Seattle • Reviewed experiences with “internal” POCMA efforts • Proposed collaborative approach in WA State • August 2012 COAP Management Committee – • Approved secure online collaborative tool developed by Armus • November 2012 – • Online tool ready for testing • January 2013 – • Anticipate online tool will be ready for collaborative use by WA hospitals ARMUS

  6. How the Bree Collaborative can support this effort: • Recognition of participation? • Promote incentives for participation? • Requirement based on mortality outcomes? • Other thoughts?? ARMUS

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