1. Improvement in Pediatric Cardiac Surgical Outcomes Through Interhospital Collaboration
- Author
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Gaies, Michael, Pasquali, Sara K, Banerjee, Mousumi, Dimick, Justin B, Birkmeyer, John D, Zhang, Wenying, Alten, Jeffrey A, Chanani, Nikhil, Cooper, David S, Costello, John M, Gaynor, J William, Ghanayem, Nancy, Jacobs, Jeffrey P, Mayer, John E, Ohye, Richard G, Scheurer, Mark A, Schwartz, Steven M, Tabbutt, Sarah, and Charpie, John R
- Subjects
Male ,Critical Care ,collaborative learning ,Clinical Trials and Supportive Activities ,Cardiorespiratory Medicine and Haematology ,outcomes ,Cardiovascular ,Congenital ,Postoperative Complications ,Clinical Research ,Humans ,Registries ,Hospital Mortality ,Cardiac Surgical Procedures ,Cooperative Behavior ,Child ,Preschool ,Heart Defects ,Pediatric ,Infant ,Evaluation of treatments and therapeutic interventions ,Newborn ,Quality Improvement ,United States ,Intensive Care Units ,Heart Disease ,Good Health and Well Being ,Cardiovascular System & Hematology ,quality ,Public Health and Health Services ,Female ,Patient Safety ,Morbidity ,6.4 Surgery ,cardiac surgery - Abstract
BackgroundPatients undergoing complex pediatric cardiac surgery remain at considerable risk of mortality and morbidity, and variation in outcomes exists across hospitals. The Pediatric Cardiac Critical Care Consortium (PC4) was formed to improve the quality of care for these patients through transparent data sharing and collaborative learning between participants.ObjectivesThe purpose of this study was to determine whether outcomes improved over time within PC4.MethodsThe study analyzed 19,600 hospitalizations (18 hospitals) in the PC4 clinical registry that included cardiovascular surgery from August 2014 to June 2018. The primary exposure was 2 years of PC4 participation; this provided adequate time for hospitals to accrue data and engage in collaborative learning. Aggregate case mix-adjusted outcomes were compared between the first 2 years of participation (baseline) and all months post-exposure. We also evaluated outcomes from the same era in a cohort of similar, non-PC4 hospitals.ResultsDuring the baseline period, there was no evidence of improvement. We observed significant improvement in the post-exposure period versus baseline for post-operative intensive care unit mortality (2.1% vs. 2.7%; 22% relative reduction [RR]; p=0.001), in-hospital mortality (2.5% vs. 3.3%; 24% RR; p=0.001), major complications (10.1% vs. 11.5%; 12% RR; p 
- Published
- 2019