CATS Quality Improvement

Vision: To build a framework to measure and report clinical markers of quality care to CATS members.

Mission: The purpose of this committee will be to promote quality care in thoracic surgery in Canada using institution and surgeon-specific prospectively collected data reported using the positive deviance framework.

A patient’s journey through thoracic surgery includes pre-operative investigations for diagnosis and staging, the intraoperative procedure, immediate postoperative care including management of adverse events, adjuvant treatments and surveillance. The framework will aim to include clinical parameters for patients assessed and treated by thoracic surgery programs encompassing the patient’s entire journey. Recognizing a balance between patient selection, quality of surgery, adverse event rates and oncologic outcomes, this initiative will measure quality care in all phases of a patient’s journey to promote the best possible outcome.

Synergy between other CATS initiatives (i.e. the Best Practices Committee and the CATS database), other national organizations (i.e. the Canadian Partnership Against Cancer (CPAC)), provincial guidelines and guidelines from other international organizations, (i.e. National Comprehensive Cancer Network (NCCN) and the American College of Chest Physicians (ACCP)) will be leveraged to select core quality parameters. A committee consisting of academic and community-based surgeons from across Canada will be used for the selection process.

The CATS database is available for collecting case-level data and postoperative adverse events. The committee will initially focus on using data that is already collected in the database or with a synoptic approach (i.e. pathology and operative reports) that can be imported into the CATS database. Over time the measures of quality will expand to include a broader patient population (i.e. non-surgical patients) and the entire patient experience from diagnosis to surveillance (i.e. appropriate staging, patient reported outcomes, etc…).

Using the positive deviance model which has already been developed and utilized by CATS, institutional and surgeon reports will be generated and distributed to surgeons so they can be evaluated against their peers.