Using Data to Improve Quality: the Pediatric Cardiac Care Consortium.
1Department of Medicine, University of Minnesota, Minneapolis, Minn, USA.
Congenital Heart Disease
|October 10, 2015
Summary
The Pediatric Cardiac Care Consortium improved pediatric cardiac surgery outcomes by enabling centers to compare performance and implement data-driven improvements. This initiative led to significant reductions in mortality rates across various congenital heart disease severity categories.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery Outcomes Research
- Health Services Research
Background:
- Established in 1982, the Pediatric Cardiac Care Consortium aimed to enhance pediatric cardiac surgery by facilitating inter-center comparison of experience and outcomes.
- Member centers submitted demographic and procedural data for analysis.
Purpose of the Study:
- To enable pediatric cardiac centers to benchmark their performance against a group of peers.
- To identify areas for improvement in surgical procedures and patient outcomes.
- To inform the development of standardized risk adjustment tools.
Main Methods:
- Data collection from 52 centers on over 137,000 pediatric cardiac operations between 1982 and 2007.
- Annual data analysis comparing individual center performance to the consortium average.
- Severity adjustment using multivariate analysis based on eight factors.
- Development of the Risk Adjustment for Surgery for Congenital Heart Disease (RACHS)-1 classification system.
Main Results:
- Mortality rates decreased across all RACHS-1 categories over the 25-year study period.
- Mortality rates for RACHS-1 categories 1 and 2 fell below 1% in the final 5 years.
- Consortium center mortality rates were comparable to aggregated state discharge data.
- Data contributed to the creation of the RACHS-1 risk adjustment tool.
Conclusions:
- The consortium model effectively facilitated performance improvement in pediatric cardiac surgery.
- Continuous data analysis and benchmarking led to substantial reductions in patient mortality.
- The RACHS-1 system provides a valuable tool for assessing and comparing surgical risk in congenital heart disease.
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