Related Experiment Video
Updated: Jan 28, 2026
Simulation of a Scaled Assembly Process with Collaboration of a Robotic Arm and Monitoring through a Vision System for Quality Control
Published on: August 29, 2025
Identifying best practices in interstage care: using a positive deviance approach within the National Pediatric
Katherine E Bates1, Sunkyung Yu1, Colleen Mangeot2
11Division of Pediatric Cardiology,Congenital Heart Center,C.S. Mott Children's Hospital,University of Michigan Medical School,Ann Arbor, MI,USA.
Insights
Low-mortality pediatric cardiology centers frequently discuss interstage results, a practice linked to better patient outcomes. This highlights the importance of outcome awareness in improving care quality.
Area of Science:
- Pediatric Cardiology
- Quality Improvement
- Healthcare Outcomes Research
Background:
- Identifying best practices in pediatric cardiology is crucial for reducing patient mortality.
- The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry provides a valuable dataset for such studies.
Purpose of the Study:
- To identify interstage best practices associated with lower mortality in pediatric cardiology centers.
- To investigate the association between specific practices and patient outcomes within the NPC-QIC.
Main Methods:
- A positive deviance approach was used, involving interviews with teams from high-performing and control centers.
- A survey assessed the adoption of identified best practices across collaborative centers.
- Center mortality rates were analyzed in relation to survey scores.
Main Results:
- Twenty potential best practices were identified, including team composition, improvement strategies, and parent engagement.
- No overall correlation was found between the general use of best practices and mortality rates.
- Frequent discussion of interstage results (at least monthly) was significantly associated with the low mortality tertile (p=0.02).
Conclusions:
- Low-mortality pediatric cardiology centers demonstrate a higher frequency of discussing interstage results compared to high-mortality centers.
- Regular outcome discussion may contribute to improved patient management and reduced mortality.
- Further research is needed to fully elucidate the factors driving outcome variations across centers.
Abstract:
IntroductionTo identify interstage best practices associated with lower mortality, we studied National Pediatric Cardiology Quality Improvement Collaborative centres registry using a positive deviance approach.
Methods:
Positive deviant and control centre team members were interviewed to identify potential interstage best practices. Subsequently, all collaborative centres were surveyed on the use of these practices to test their associations with centre mortality. Questionnaires were scored using Likert scales; the overall score was linearly transformed to a 0-100-point scale with higher scores indicating increased use of practices. Mortality was based on patients enrolled after a centre's first year in the collaborative. Centre mortality rates were divided into tertiles. Survey scores for the low mortality tertile were compared with the other tertiles.
Results:
For this study, seven positive deviant and four control teams were interviewed. A total of 20 potential best practices were identified, including team composition, improvement practices, and parent involvement. Questionnaires were completed by 36/43 eligible centres, providing 1504 patients for analysis. Average survey score was 50.2 (SD 13.4). Average mortality was 6.1% (SD 4.1). There was no correlation between survey scores and mortality (r=0.14, p=0.41). The one practice associated with the low mortality tertile was frequency of discussion of interstage results: 58.3% of low mortality teams discussed results at least monthly versus 8.4% of the middle and high tertile centres (p=0.02).
Conclusions:
Low-mortality centres more frequently discuss interstage results than high-mortality centres. Heightened awareness of outcomes may influence practice; however, further study is needed to understand the variation in outcomes across centres.
More Related Videos
04:00Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
Published on: July 26, 2024
05:56Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
Published on: August 29, 2025
Related Concept Videos
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:26National Nursing Organizations I
01:30National Nursing Organizations II
The AACN emphasizes a healthy work environment through six standards to achieve an optimal patient outcome. The standards are appropriate staffing, meaningful recognition, collaboration, authentic leadership, effective communication, and decision-making. In addition, AACN provides certification programs, webinars, journals, and...
01:30Design Example: Identifying the Locations of Monuments in the Field Using Global Positioning System Device
02:32Position-effect Variegation
01:21Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...