The Pediatric Cardiac Care Consortium: a physician-managed clinical review program

A voluntary physician-initiated and physician-managed clinical review program for pediatric cardiology uses clinical practice data and expected outcome to influence physicians to change their clinical behavior. The program offers a model for clinical review in situations where disease incidence is relatively low and physician performance is difficult to assess and evaluate. The program's major accomplishment is a collective pooling of data across cardiac centers that allows for statistical analysis and comparison not routinely possible at a single center because of sample size; a forum for comparison of different practice styles; and feedback to participants of actual, in contrast to anecdotal, results. The principles, structure, and format of the program can be applied to other specialty areas.