Program Questions
Research and Reporting
Who gets the COAP reports at each hospital?
As one of its methods to protect hospital-specific information from accidental disclosure, COAP distributes a limited number of reports: reports are sent to the individual at each hospital who signed the contract between COAP and that hospital, and to others as requested in writing by that individual. Each hospital determines how to distribute the reports or share the information internally according to its own quality improvement policies and mechanisms. Please contact the Program Director with any questions about or requested changes to report distribution.
Will publicly released report cards be generated from these data?
No. Unlike other states that have collected cardiac outcomes data with the goal of producing report cards, COAP has been designed as a mechanism for internal quality improvement activities. COAP is protected under state law from discoverability as a quality improvement activity (RCW 43.70.510). No identified data may be released by COAP without written consent from the respective party.
Will the reporting system lead some physicians to refuse to perform procedures on high-risk cases out of fear of looking bad in the reports?
Among the foremost objectives of the program is how to optimize treatment outcomes for patients with coronary artery disease. If high-risk patients are turned down for a procedure, the provider’s procedure-specific mortality rate may indeed be reduced. However, if that treatment was the best option for those patients, more patients may unnecessarily die or do poorly. By examining multiple modalities of revascularization, physicians will have tools to help assess the optimal approach to the treatment of coronary disease, including those in the highest risk groups. Using credible, risk-adjusted information from the COAP registry to augment clinical decision-making, physicians are expected to experience improved outcomes for patients with coronary artery disease.
Will physicians have access to data collected through the institutions?
Yes. An important lesson learned from other statewide models is that credibility among physicians is paramount. COAP has approached this through developing a physician-led program, where the needs and concerns of the physician community are addressed in partnership with other stakeholders. Physician access to meaningful data is integral to a viable and credible data collection effort. Physicians will have access to COAP data through their respective institutions as defined in the contract between COAP and the institutions. In addition, for an additional fee physicians may request reports directly from COAP either to review their own patient-specific elements to confirm validity, or to examine their aggregate results compared to peer group norms.
Will hospitals that perform procedures on high-risk cases or cases turned down by other physicians look bad in the reports?
Effective quality improvement can only occur if analyses are perceived as fair and credible. If well accepted and validated risk-adjustment techniques prove unable to account for case-mix, the physician-led Management Committee will be charged with the responsibility of working collaboratively to identify appropriate alternatives. Physicians and institutions need not be penalized for electing to take on the most challenging cases.
What is the future of COAP?
COAP’s Management Committee has developed a Strategic Plan for the next several years, with a major focus on proactive quality improvement. COAP has developed and distributed additional reports of selected risk-adjusted CABG and PCI indicators to help hospitals identify trends, and will work closely with the hospitals to support actions to correct any opportunities for improvement.
