Power of a Learning Network in Congenital Heart Disease
| Autor: | Nancy Rudd, David W. Brown, Jim Tweddell, Carole Lannon, Andrew H. Van Bergen, Colleen Mangeot, Jeffrey B. Anderson, Samuel P. Hanke, Katherine E. Bates, Stacy Lihn |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Quality management Heart disease Cardiology 030204 cardiovascular system & hematology Norwood Procedures Hypoplastic left heart syndrome 03 medical and health sciences 0302 clinical medicine Learning network Medicine Humans 030212 general & internal medicine Registries Intensive care medicine Retrospective Studies business.industry Palliative Care Infant Newborn Infant General Medicine medicine.disease Quality Improvement United States Survival Rate Treatment Outcome Education Medical Graduate Pediatrics Perinatology and Child Health Surgery Female Cardiology and Cardiovascular Medicine business Pediatric cardiology |
| Zdroj: | World journal for pediatriccongenital heart surgery. 10(1) |
| ISSN: | 2150-136X |
| Popis: | Background: The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) formed to improve outcomes in infants with hypoplastic left heart syndrome. The collaborative sought to (1) decrease mortality, (2) reduce growth failure, and (3) reduce hospital readmissions due to major medical problems during the interstage period between discharge following stage 1 palliation (S1P) and admission for stage 2 palliation (S2P). Methods: The NPC-QIC is a learning network, coproduced by parents and clinicians, of 65 pediatric cardiology centers that contribute clinical data on care processes and outcomes to a shared registry. The adapted Breakthrough Series Model structure brings teams together regularly to review data, share lessons, and plan improvements. Outcomes are monitored using statistical process control methods. Results: Between 2008 and 2016, interstage mortality decreased by >40%, from 9.5% to 5.3%. Identification and use of a nutrition bundle led to improved infant growth, with a 28% reduction in interstage growth failure. The rate of serious hospital readmissions was low and did not significantly change. Importantly, a formed partnership with the parent group Sisters by Heart fostered the coproduction of tools and strategies and an emphasis on data transparency and outcomes. Conclusions: The NPC-QIC’s initial efforts led to improvements in interstage growth and mortality. The NPC-QIC has modeled the use of data for improvement and research, the value of coproduction with parents, and the concept “all teach, all learn,” demonstrating the power of the learning network model. |
| Databáze: | OpenAIRE |
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