Power of a Learning Network in Congenital Heart Disease

Area of Science:

• Pediatric Cardiology
• Quality Improvement Science
• Congenital Heart Disease Research

Background:

• The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) was established to enhance outcomes for infants diagnosed with hypoplastic left heart syndrome.
• Key objectives included reducing mortality, preventing growth failure, and minimizing hospital readmissions during the critical interstage period between surgical palliation stages.

Purpose of the Study:

• To assess the impact of a collaborative quality improvement initiative on interstage outcomes for infants with hypoplastic left heart syndrome.
• To evaluate the effectiveness of a learning network model in improving clinical care processes and patient results.

Main Methods:

• A learning network comprising 65 pediatric cardiology centers was established, utilizing a shared clinical data registry.
• The Breakthrough Series Model guided regular team meetings for data review, knowledge sharing, and improvement planning.
• Statistical process control methods were employed for continuous outcome monitoring.

Main Results:

• Interstage mortality experienced a significant decrease of over 40% (from 9.5% to 5.3%) between 2008 and 2016.
• Implementation of a nutrition bundle resulted in a 28% reduction in interstage growth failure, improving infant growth.
• The rate of serious hospital readmissions remained low and showed no significant change.

Conclusions:

• The NPC-QIC successfully improved interstage growth and reduced mortality in infants with hypoplastic left heart syndrome.
• The collaborative demonstrated the power of a learning network model, emphasizing data-driven improvement, parent-clinician coproduction, and shared learning.