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Implantation of Total Artificial Heart in Congenital Heart Disease
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The Congenital Heart Technical Skill Study: Rationale and Design.
Brett R Anderson1, S Ram Kumar2, Danielle Gottlieb-Sen3
11 Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY, USA.
World Journal for Pediatric & Congenital Heart Surgery
|March 8, 2019
Summary
Congenital heart surgeons are participating in a peer-evaluation program using video observation to assess technical skills. This initiative aims to improve surgical quality through feedback and performance data.
Area of Science:
- Cardiothoracic Surgery
- Surgical Education
- Quality Improvement
Background:
- Developing objective methods to assess surgeon technical skill is crucial in congenital heart surgery.
- Peer evaluation using direct observation offers a potential avenue for skill assessment and feedback.
Purpose of the Study:
- To report the design and rationale of a peer-evaluation protocol for attending congenital heart surgeon technical skill.
- To establish a system for evaluating surgical technique through video observation and peer review.
Main Methods:
- Surgeons participating in The Society of Thoracic Surgeons-Congenital Heart Surgery Database (STS-CHSD) can submit videos of specific procedures (Norwood, AV canal repair, arterial switch).
- A HIPAA-compliant website facilitates secure video submission and anonymous peer rating using a modified Objective Structured Assessment of Technical Skills (OSATS) score.
- Peer ratings are linked to five years of STS-CHSD outcome data and surgeon questionnaires to assess technical skill in relation to patient outcomes.
Main Results:
- Recruitment is ongoing, with 83 surgeons (30%) from 53 centers (45%) participating.
- Participants represent a range of experience levels and report the process as rewarding and efficient.
- Initial analysis of 10 videos showed excellent interrater reliability (interclass correlation = 0.85).
Conclusions:
- A significant proportion of congenital heart surgeons across the US are engaging in this video-based peer-evaluation program.
- The protocol provides a mechanism for peer feedback, with the hypothesis that this feedback will drive quality improvement in congenital heart surgery.
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