Technical Assessment Project

 

CHSS Technical Assessment Project (TAP) 

Dear CHSS Members:

As we have discussed at many of the work weekends over the past 2 years, objective criteria that ‘measure’ technical performance of common operations can be a useful method to provide feedback and improve individual surgeon/institution performance. We are pleased to announce that the web-based TAP modules are now functional.

The modules are confidential and meant for the use of individual surgeons. Data can certainly be aggregated and shared upon request, but the intent of these modules is to provide our membership with an objective and useful comparison metric.

By way of a brief introduction to this important opportunity, Bacha and colleagues first described the use of a technical performance score (TPS). The TPS ‘measures’ specific components of an operation (for example VSD closure and relief of RVOTO for Tetralogy of Fallot). The premise is that, by scoring different elements of the repair, an individual surgeon will gain insight into those parts of an operation very well, but might be able to improve on others. TPS has also been correlated with short and mid-term outcomes and is being critically evaluated and refined in a new PHN trial.

Predicated on these initial promising data, coupled with the thought that surgeons could derive tangible benefit from a simple method to assess their own performance relative to a larger group, the CHSS Data Center convened a taskforce to customize technical assessment modules for four individual operations:

1. ventricular septal defect closure
2. tetralogy of fallot repair
3. complete atrioventricular canal
4. transposition +/- VSD 

You will access the REDCap system following one of these four operations, and enter the requested surgical data. The data forms are brief and should not require more than 5 minutes to complete. Following that, a person designated by you will enter data from the pre-discharge echo (in keeping with prior protocols using TPS).

Although considerable thought has been devoted to the development of these initial data entry forms, they are the first iteration, and we welcome your comments and suggestions in the coming year as you use the module.

Each case you enter can be reviewed for accuracy. Reports of your TPA will be readily available to you (& you only) and can be compared to the anonymous aggregate experience of all users. Clearly, the individual entering data will likely be entering data for all of the surgeons at each institution, but a variable in the database will be utilized to differentiate one surgeon from another using an assigned code. Each surgeon will be de-identified using this numeric code that will be kept confidential in the Data Center and the individual entering data at each institution.

We are very excited to provide the membership with this service and look forward to your feedback as we begin this process.

Bill DeCampli
Managing Director
CHSS Data Center
Toronto