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Impact of Partnership Between Children's HeartLink and IQIC Database With a Pediatric Cardiology and Cardiovascular

Ulisses Alexandre Croti1, Alexandre Noboru Murakami2, Carlos H De Marchi1

  • 11 Department of Pediatric Cardiology and Cardiovascular Surgery, Hospital da Criança e Maternidade-São José do Rio Preto Medical School (FAMERP), São Paulo, Brazil.

World Journal for Pediatric & Congenital Heart Surgery
|May 16, 2019
PubMed

Insights

Children's HeartLink (CHL) and the International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC) partnership reduced infections and mortality in pediatric heart patients. This seven-year analysis guided improvements despite increasing patient complexity.

Area of Science:

  • Cardiology
  • Pediatric Cardiovascular Surgery
  • Quality Improvement in Healthcare

Background:

  • Children's HeartLink (CHL) supports developing countries' cardiology centers.
  • The International Quality Improvement Collaborative Database for Congenital Heart Disease (IQIC) database aids quality improvement.
  • This study analyzes a seven-year partnership between CHL and a pediatric center using the IQIC database.

Purpose of the Study:

  • To evaluate the impact of the CHL-IQIC partnership on pediatric congenital heart disease outcomes.
  • To guide interventions for reducing morbidity and mortality in pediatric cardiology and cardiovascular surgery.
  • To analyze the effectiveness of quality improvement initiatives in a developing country's specialized center.

Main Methods:

  • Data collected from January 2011 to December 2017 with external audits.
  • Included preoperative data (demographics, nutritional status, chromosomal abnormalities) and Risk Adjustment for Congenital Heart Surgery (RACHS-1) scores.
  • Postoperative data included infections, complications within 30 days, or until discharge/death.

Main Results:

  • Increased number of newborn patients and higher surgical risk categories (4-6) over time.
  • Significant decrease in surgical site infections (P=.03) and bacterial/other infections (P<.001).
  • Observed a trend toward decreased in-hospital (P=.16) and 30-day mortality (P=.14).

Conclusions:

  • The CHL-IQIC partnership identified and resolved structural and human flaws.
  • Improvements led to a significant reduction in infections and mortality.
  • The center successfully managed an increasingly complex pediatric congenital heart disease population.
Abstract

Keywords:
congenital heart diseasedatabasedeveloping countriesquality improvement

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