A Risk Management Strategy for Managing Critical Human Resource Changes in a Pediatric Heart Program.

Area of Science:

• Pediatric Cardiac Surgery
• Quality Improvement Initiatives
• Healthcare Management

Background:

• Expertise loss in pediatric heart programs due to staff changes can risk patient outcomes.
• A quality initiative was developed for risk management during critical staff transitions.
• The Ramp Down/Up protocol systematically adjusts case complexity to mitigate risks.

Purpose of the Study:

• To implement and evaluate a risk management strategy for pediatric heart programs facing staff changes.
• To ensure patient safety and maintain outcomes during critical fluxes in expert staff.
• To introduce a systematic protocol for managing case complexity during staff transitions.

Main Methods:

• The study involved a quality initiative approved by the Institutional Ethics Review Board.
• Data collection included patient/caregiver consent, focusing on index cardiac surgical procedures from 2003-2015.
• The Ramp Down/Up protocol incorporated a complexity reduction trigger, an external observer, complexity escalation, and data analysis.

Main Results:

• The Ramp Down/Up protocol was utilized three times over 12 years for staff challenges, lasting 3.5-9 months each.
• Patient operative mortality rates remained stable and were benchmarked against the Congenital Cardiac Surgery database.
• Outcomes were consistently maintained during and after the protocol's implementation.

Conclusions:

• A risk management quality initiative successfully maintained patient outcomes in a pediatric heart team.
• The Ramp Down/Up protocol proved effective in navigating critical human resource changes.
• This systematic approach ensures program stability and patient safety during staff fluctuations.