Playing by the numbers: how collecting outcomes data changed by life.

The Northern New England Cardiovascular Study Group has been using clinical epidemiology to analyze outcomes data in patients undergoing cardiac surgical procedures to answer three questions: (1) for the surgeon: how am I doing?, (2) for the patient: what are my chances?, and (3) for society: can outcomes data be voluntarily collected and organized in a way to improve care delivery? The Dartmouth-Hitchcock Medical Center cardiac surgery program has combined this regional outcomes data with the internal development of critical pathways; with evaluations of patient expectations, patient satisfaction, and patient functional health; and with innovative techniques of data display in an effort to improve the cardiac surgical outcomes in patients at the center. The length of stay has declined, and both the mortality rate and readmission rate have remained stable.