California Society of Thoracic Surgeons (CASTS)
Southern California Regional Collaborative Project
April 25, 2012
To: Southern California Cardiac Surgery Teams
From: Joseph S. Carey M.D., Project Director

The CA STS is initiating a regional collaborative quality improvement project for Southern California cardiac surgery teams. The project has been designed with input and support from the leadership of the National STS, who have increasingly recognized the value of regional initiatives, through the effort will be driven locally. The project is supported by private foundation funding to provide for IT infrastructure, meetings and other developmental expenses.

While the primary goal is to improve the care of patients requiring cardiac surgery and interventions, regional collaboratives have also been shown to improve the practice environment of cardiovascular specialists. Sharing outcome data and care processes in pursuit of common goals has led to more consistent used of best practices. In particular, concordant decision making among surgeons and cardiologists will be stressed in this project.

The CA STS has updated its web sites to provide high quality reports on all cardiac surgery and percutaneous coronary intervention (PCI) procedures performed in California through 2010. We are in the process of validating procedure volumes and mortality rates using the state vital statistics and linked PDD-Death files. Directories of heart hospitals and heart surgeons have been created. It is important that we make these information sources as accurate as possible. Therefore we are asking you to review the links to your hospital and physician web sites that are provided on the CA STS home page and to review the data that is reported.

The CA STS reports compliment other sources of outcome information such as the CCORP and the STS National Database, which include data on the index hospitalization only, by including on hospital readmission for additional procedures or complications. The Southern California Regional Collaborative Project will [provide and additional set of robust reports from aggregated STS national database data.

The project will also be discussed at the May 16 CA STS data managers meeting at UCLA. Summaries of the project and its goals are posted in the resources section of the CA STS website.


  1. Maximus S, Milliken JC, Danielsen B, Shemin R, Khan J, Carey JS. Implementation of transcatheter aortic valve replacement in California: Influence on aortic valve surgery. J Thorac Cardiovasc Surg. 2018 Apr;155(4):1447-1456. doi: 10.1016/j.jtcvs.2017.07.092. Epub 2018 Jan 4. PubMed PMID: 29554785.
  2. Maximus S, Milliken JC, Danielsen B, Khan J, Shemin R, Carey JS. Defining operative mortality: Impact on outcome reporting. J Thorac Cardiovasc Surg. 2016 Apr;151(4):1101-7. doi: 10.1016/j.jtcvs.2015.10.062. Epub 2015 Oct 27. PubMed PMID: 26876420.
  3. Milliken JC, Rudersdorf PD, Carey JS, Danielsen B. Cause and effects of decreasing coronary revascularization procedures in California hospitals, 2006 to 2010. Am J Cardiol. 2014 Feb 1;113(3):465-70. doi: 10.1016/j.amjcard.2013.10.028. Epub 2013 Nov 9. PubMed PMID: 24321898.
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  8. Carey JS, Danielsen B, Gold JP, Rossiter SJ. Procedure rates and outcomes of coronary revascularization procedures in California and New York. J Thorac Cardiovasc Surg. 2005 Jun;129(6):1276-82. PubMed PMID: 15942567.
  9. Carey JS, Parker JP, Robertson JM, Misbach GA, Fisher AL. Hospital discharge to other healthcare facilities: impact on in-hospital mortality. J Am Coll Surg. 2003 Nov;197(5):806-12. PubMed PMID: 14585418.
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  11. Carey JS, Dziuban SW, Arom KV, Cimochowski GE, Plume SK, Grover FL. Quality improvement in thoracic surgery. Bull Am Coll Surg. 1998 May;83(5):24-9. PubMed PMID: 10179849.
  12. Edwards FH, Carey JS, Grover FL, Bero JW, Hartz RS. Impact of gender on coronary bypass operative mortality. Ann Thorac Surg. 1998 Jul;66(1):125-31. PubMed PMID: 9692451.
  13. Carey JS, Cukingnan RA, Singer LK. Health status after myocardial revascularization: inferior results in women. Ann Thorac Surg. 1995 Jan;59(1):112-7. PubMed PMID: 7818310.
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