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Developing Congenital Cardiac CT Services in Low-Resource Settings: A Quality Improvement Approach
Shazia Mohsin1, Saira Siddiqui2,3,4, Tahira Gill5
1Section of Pediatric Cardiology, Division of Cardiothoracic Sciences, Sindh Institute of Urology and Transplantation, Karachi, Pakistan. shzmhsn@gmail.com.
Pediatric Cardiology
|August 22, 2025
Summary
Implementing high-quality congenital cardiac computed tomography (CCT) in low-resource settings is achievable. Structured quality improvement methods and virtual mentorship significantly improved safety and diagnostic accuracy for congenital heart disease (CHD) evaluations.
Area of Science:
- Medical Imaging
- Cardiology
- Quality Improvement
Background:
- Congenital heart disease (CHD) evaluation using cardiac computed tomography (CCT) is underutilized in low and middle-income countries (LMICs).
- Barriers include limited training and systemic challenges.
- Structured quality improvement (QI) strategies for safe CCT implementation are scarce.
Purpose of the Study:
- To implement a high-quality congenital CCT service in a resource-limited public hospital.
- To utilize structured QI methods, multidisciplinary collaboration, and innovative training.
Main Methods:
- Initiative conducted at a public tertiary hospital in Pakistan (Jan 2023 - Jun 2024).
- Interventions: protocol development, vendor training, remote mentorship, diagnostic review.
- Monitored metrics: radiation dose, tube voltage, diagnostic error rate (DER), sedation-related adverse events (SER).
Main Results:
- 118 congenital CCT scans performed.
- Median radiation dose decreased significantly (915 to 62 mGy*cm).
- Tube voltage optimization reached 100%, DER and SER reduced to 0% post-intervention and were sustained.
Conclusions:
- Congenital CCT services can be safely implemented in low-resource settings.
- Structured QI, mentorship, and collaboration are key.
- This model is potentially applicable to similar healthcare environments.
Keywords:
Capacity buildingCongenital cardiac CTCongenital heart diseaseDiagnostic errorLow- and middle-income countriesMultidisciplinary collaborationQuality improvementRadiation dose optimizationSustainable health systemsVirtual mentorshipMore Related Videos
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