Coronary bypass surgery: From variability to standardization?

Purpose of review The review summarizes recent literature on standardization of care in coronary artery bypass grafting (CABG), with particular attention to the impact of standardization on outcomes and resource utilization. Recent findings An increasing number of studies have demonstrated potential advantages to standardization in CABG. Certain process measures such as specific medications at discharge, selection and duration of antibiotic prophylaxis, and use of the internal mammary artery have been advocated as quality indicators in CABG and have contributed to standardized care and improvement in outcomes. In addition, as the potentially harmful consequences of blood transfusions are increasingly being recognized, efforts to standardize transfusion practices in CABG have been undertaken. Nevertheless, despite recognition that uniformity of care improves outcomes, evidence suggests that there continues to be substantial variability between hospitals in the delivery of care to the CABG patient. Summary There continue to be opportunities for further identification and implementation of cost-effective pathways to lower overall resource utilization while improving outcomes in CABG patients.