A statewide quality collaborative for process improvement: internal mammary artery utilization.

Background: The Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS) Quality Collaborative is a voluntary, surgeon-directed quality initiative involving all cardiac surgery programs in Michigan. Understanding that internal mammary artery (IMA) use during coronary artery bypass grafting is an important process measure associated with improved outcomes, this analysis reviews our methodology to understand IMA use and increase appropriate IMA use statewide.

Methods: Adult cardiac Society of Thoracic Surgeons data were collected at each Michigan site and submitted quarterly to the Duke Clinical Research Institute and the MSTCVS.

Cardiac surgeons and the quality movement: the Michigan experience.

The Michigan Society of Thoracic and Cardiovascular Surgeons created a voluntary quality collaborative with all the cardiac surgeons in the state and all hospitals doing adult cardiac surgery. Utilizing this collaborative over the last 3 years and creating a unique relationship with a payor, an approach to processes and outcomes has produced improvements in the quality of care for cardiac patients in the state of Michigan.

From 'acting on' to 'acting with': the functional anatomy of object-oriented action schemata.

In this chapter it is proposed that object-based actions can be broadly classified into types. In the first, objects are 'acted on' without a specific purpose. In the second, objects are 'acted with'.

Intact motor imagery in chronic upper limb hemiplegics: evidence for activity-independent action representations.

Four experiments were undertaken to examine the effects of chronic hemiplegia on the ability to internally represent actions involving either the paralyzed (contralesional) or relatively unaffected (ipsilesional) limb. An experimental group of chronic, densely hemiplegic patients was compared with controls who experienced nearly full recovery from an initially dense hemiparesis. All participants suffered cerebral vascular accidents that spared sites in premotor and parietal areas directly involved in representing upper limb actions.

Viewpoint-dependent recognition of scenes.

Three experiments investigated scene recognition across viewpoint changes, involving same/different judgements on scenes consisting of three objects on a desktop. On same trials, the comparison scene appeared either from the same viewpoint as the standard scene or from a different viewpoint with the desktop rotated about one or more axes. Different trials were created either by interchanging the locations of two or three of the objects (location change condition), or by rotating either one or all three of the objects around their vertical axes (orientation change condition).