Dr. David Adams

……implemented during the past year, including:
……Launching an ambitious Quality Program that will harness the power of data to improve both surgical performance and patient outcomes.
……

five actions in 2019 to help translate these abstractions into reality:

Learn one aspect of surgery better than your peers, and be generous with your expertise among your partners and colleagues.
Stay current on the latest guidelines and innovations, and put patients into clinical trials to help create the evidence base that shapes the future of cardiothoracic surgery.
Engage with the AATS Foundation and become a donor, to underwrite the scholarship that advances its mission.
Support the new Quality Program, collaborating to realize the true potential and power of data to improve patient outcomes.
Proactively mentor someone to pass on both experience and values, or if you are younger and don’t have a mentor, actively seek one out.

Tirone E. David, MD

……Dr. David summarized what he thought were the seven main components:

1) caring and compassion for your patients (even if you have to fake it);

2) a sound knowledge of anatomy, physiology, and pathology;

3) precision and attention to details, no matter how small;

4) dexterity and efficiency, making every movement count;

5) team work: surgery is like a symphony;

6) follow-up: continuous observation and surgical correlation from the operation to the grave;

7) surgical creativity: moving the bar to a new level of excellence.

Dr. David stressed the need to develop the insight to evaluate your mistakes and to learn from them as a key overall component of rising to new heights of surgical excellence. He added that it was very important that external challenges and reviewers – the gatekeepers of the field – assess and critique your development.

Eugene H. Blackstone, MD, of the Cleveland Clinic Foundation

“Given the enormous strides in communication, the internet, and computer technology on the one hand, and data science with machine learning and artificial intelligence on the other, what would a quality assessment program, squarely focused on those three questions, look like if it were developed from the ground up in the 21st century?”

It would be a single, cloud-hosted solution, said Dr. Blackstone, comprised of core quality datasets, which would be right-sized for adult cardiac, general thoracic, and pediatric and congenital heart disease.

“We are proposing a vision of resources and collaborative discussions focused on how we improve. ...We envision multiple sites connecting themselves as a peer group, with no geographical boundaries, to develop and execute quality initiatives to help us improve,” he added.

“For the patient asking ‘What are my chances?’ we will provide risk assessment across all procedures, providing individualized and site-specific prediction of risk for counseling and informed consent,” said Dr. Blackstone.

“Why should you support the new AATS Quality Assessment Program?” he asked. “It can give you the information that you and your patients need at low cost.”

The program will also be available 24/7/365 for self-service data analytics with the latest data science methods applied to provide personalized risk assessment. Importantly, it will also engender improved peer-to-peer collaboration without geographic boundaries.

Former AATS President Pedro del Nido commented, saying: “The ability of surgeons to collaborate and work in developing better solutions for their patients is a critical part of this program. That’s what we have not had the capability to do up until now. We are trying to develop a system where individual surgeons can share their results in a way that doesn’t make them worried that somehow they are going to be judged by individuals who don’t understand their practice. Because otherwise what you are going to do is inhibit innovation, and you are going to make surgeons risk averse. The willingness to innovate has been the hallmark of our profession,” he concluded.

After Dr. Blackstone’s presentation, Jeffrey B. Rich, MD, Past-President of the Society of Thoracic Surgeons, as part of a panel of experts assembled to answer questions stated: “This contemporary quality program is unique. It’s not a brick and mortar database with legacy data, it’s a live, dynamic, interactive technology data platform.” He added that the new platform would be able to codify the up to 60% of patients that fall outside of other databases.