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Updated: Jan 27, 2026
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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
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Improved Teamwork and Implementation of Clinical Pathways in a Congenital Heart Surgery Program.
Tina Schade Willis1, Theodore Yip2, Karla Brown3
1Indiana University Department of Pediatrics, Division of Critical Care Medicine Indianapolis, IN.
Pediatric Quality & Safety
|April 3, 2019
Summary
Teamwork training and Integrated Clinical Pathways (ICPs) improved care for pediatric congenital heart surgery patients. ICPs reduced intubation time, demonstrating the value of structured teamwork and infrastructure for sustained improvements.
Area of Science:
- Surgical Care Improvement
- Healthcare Management
- Pediatric Cardiology
Background:
- Complex surgical patients face higher morbidity risks due to care variations and poor teamwork.
- Improving teamwork and standardizing care are crucial for high-risk patient populations.
Purpose of the Study:
- To enhance teamwork and reduce care variations in pediatric congenital heart surgery.
- To implement Integrated Clinical Pathways (ICPs) supported by teamwork training.
Main Methods:
- Utilized project management and established a new operations infrastructure for program implementation.
- Delivered teamwork training and coaching to care teams.
- Designed and implemented ICPs through iterative testing with expert input.
Main Results:
- Significant teamwork improvement observed in 3 of 4 units post-training.
- Integrated Clinical Pathways (ICPs) were implemented in two patient subpopulations.
- A decrease in total intubation hours was detected in ICP patient groups; length of stay did not significantly change.
Conclusions:
- Effective teamwork training and coaching programs can enhance team collaboration.
- Integrated Clinical Pathways (ICPs) are sustainable with a strong supporting infrastructure, including leadership, buy-in, project management, and continuous measurement.
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