2021 application/pdf 1784219 bytes eng The annals of thoracic surgery 112(1) Quality improvement: arterial grafting redux, 2010:2019 Key words: multiple arterial grafting, quality improvement initiative, utilization rates Bond, Chris J. Milojević, Milan He, Chang Theurer, Patricia F. Clark, Melissa Pruitt, Andrew L. Gandhi, Divyakant DeLucia, Alphonse Jones, Robert N. Dabir, Reza Prager, Richard L. BACKGROUND: The evidence base favoring utilization of multiple arterial conduits in coronary artery bypass grafting has strengthened in recent years. Neverthe- less, utilization of arterial conduits in the US lags behind that of many European peers. We describe a statewide collaborative based approach to improving utilization. METHODS: Four metrics of arterial revascularization were devised. These were displayed and discussed at quarterly statewide quality collaborative meetings from January 2016 onwards, integrated with an educational program regarding attendant benefits. We undertook retrospective review of isolated coronary artery bypass grafting statewide from 2012-2019 to assess impact. RESULTS: A total of 38,523 cases met inclusion/exclusion criteria. Statewide incidence of multiple arterial grafting increased from 7.4% at baseline to 21.7% in 2019 (P < .001), implementation across hospitals varied widely, ranging from 67.6% to 0.0%. Utilization of total arterial revascu- larization increased 1.9% to 4.4% (P < .001) between time frames. Utilization of both radial artery and bilateral internal thoracic artery conduit increased significantly from 5.3% to 13.2% (P < .001) and 2.1% to 8.5% (P < .001), respectively; radial artery utilization was significantly higher than bilateral internal thoracic artery for each year (P < .001 for all comparisons). CONCLUSIONS: Our statewide quality improvement initiative improved rates of utilization of multiple arterial grafting by all metrics. Barriers to current utilization were identified to guide future quality improvement efforts. This reproducible approach is readily transferable to improve quality of care in other domains and geograph- ical areas. Appendix 1: https://unilib.phaidrabg.rs/o:3270 Appendix 2: https://unilib.phaidrabg.rs/o:3271 info:eu-repo/semantics/article https://unilib.phaidrabg.rs/o:3269 doi:10.1016/j.athoracsur.2020.08.072 cobiss:128797193 ISSN: 1552-6259 All rights reserved