o:3269 Quality improvement: arterial grafting redux, 2010:2019 en 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 Key words: multiple arterial grafting, quality improvement initiative, utilization rates 91552100 128797193 1552101 1552-6259 1552099 10.1016/j.athoracsur.2020.08.072 2023-11-17T20:16:49.381Z 44 yes 46 Chris J. Bond 106420489 2019 46 Milan Milojević 106163721 0000-0003-0984-9011 2019 46 Chang He 46 Patricia F. Theurer 46 Melissa Clark 46 Andrew L. Pruitt 46 Divyakant Gandhi 46 Alphonse DeLucia 46 Robert N. Jones 46 Reza Dabir 46 Richard L. Prager application/pdf 1784219 https://unilib.phaidrabg.rs/o:3269 no yes 1 70 616.1-089 92000001 71A11 The annals of thoracic surgery 112 1 22 30 2021