STS Public Reporting Online includes the following important features:
- It is a voluntary initiative, although its success depends on widespread participation by STS Adult Cardiac Surgery Database participants.
- The units of analysis for public reporting are both the hospital and the Database “Participant” (a term of art used by the Society to identify a given surgeon or, more commonly, a group of surgeons participating as a unit in the STS National Database). In most cases, hospital and Database Participant are identical (i.e., the Participant is composed of all surgeons performing cardiothoracic surgery at a given hospital), but in some instances more than one Participant may practice at a given hospital, or one Participant may practice at more than one hospital. Database Participants will continue to receive their confidential Participant-level reports, but STS’s public reports will also provide hospital-level performance. STS has no current plans to report at the individual surgeon level.
- Initial public reporting efforts focused on coronary artery bypass grafting (CABG) surgery, as it is the most frequently performed and extensively studied cardiothoracic surgical procedure. Two years after the launch of STS Public Reporting Online, the second most commonly performed heart operation, aortic valve replacement (AVR) surgery, has subsequently been included.
- The STS composite CABG score and star rating and its component domain (risk-adjusted mortality; major morbidity; use of internal mammary artery; and prescribing of peri-operative medications) scores and ratings; and the STS composite AVR score and star rating and its component domain (risk-adjusted mortality and major morbidity) scores and ratings will be used for public reporting. This methodology is widely accepted by all stakeholders and is the most comprehensive measure of cardiothoracic surgery quality currently available.
- The public reporting format is constructed in such a way that direct comparison of individual hospitals with each other is discouraged. Rather, the numerical scores or their associated star ratings are an indication of how a participant’s results compare with the average performance of all Database Participants. One-star or three-star ratings indicate a very high statistical certainty that a participant’s performance is below or above average, respectively.