Improvement in Interstage Survival in a National Pediatric Cardiology Learning Network

Anderson, Jeffrey B.; Beekman, Robert H.; Kugler, John D.; Rosenthal, Geoffrey L.; Jenkins, Kathy J.; Klitzner, Thomas S.; Martin, Gerard R.; Neish, Steven R.; Brown, David W.; Mangeot, Colleen; King, Eileen; Peterson, Laura E.; Provost, Lloyd; Lannon, Carole

doi:10.1161/circoutcomes.115.001956

Cited by 142 publications

(135 citation statements)

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“…Recently published data in a separate NPC-QIC study including more contemporary data may begin to shed some light on some of these questions. 4 Results of that study, which examined interstage mortality rates over time within the NPC-QIC by using statistical process control methodology, suggest no change in mortality rates initially (during the time period of the present study), but trends toward decreasing mortality within the collaborative more recently beginning in 2013. 4 Another important factor to consider is the impact of the center.…”

Section: Article See P 502mentioning

confidence: 58%

“…4 Results of that study, which examined interstage mortality rates over time within the NPC-QIC by using statistical process control methodology, suggest no change in mortality rates initially (during the time period of the present study), but trends toward decreasing mortality within the collaborative more recently beginning in 2013. 4 Another important factor to consider is the impact of the center. In the present study, it is reported that 1 type of strategy or frequency of home monitoring was typically used at each center within the collaborative.…”

Section: Article See P 502mentioning

confidence: 58%

“…4 The first project initiated by the collaborative focused on the interstage period, with a primary goal of reducing interstage mortality and improving quality of life. The key drivers that were deemed necessary to achieve these goals included engaging parents, improving care transitions at Norwood discharge, optimizing growth, and improving coordination among the care team and families.…”

Section: Article See P 502mentioning

confidence: 99%

“…4 Multiple change strategies or activities in these areas were recommended for centers participating in the collaborative including caregiver preparation during the Norwood hospitalization; providing caregivers with a red flag action plan; establishing collaboration between the family, primary physician, cardiologist, and other team members; activities related to assessment and optimization of feeding and weight gain; standardization of assessments and action plans at clinic visits; and home monitoring during the interstage period of oxygen saturation and weight gain. 4 The latter component is integrated with many of the other activities, and was included primarily based on a 2003 study from the Children's Hospital of Wisconsin that demonstrated a decrease in interstage mortality from 16% in historical controls to 0% following the introduction of a comprehensive home-monitoring program at their institution. 5 In this issue of Circulation, Oster and colleagues 6 evaluate the association between home monitoring and interstage mortality, readmissions, and weight gain in a multicenter cohort of NPC-QIC centers.…”

Section: Article See P 502mentioning

confidence: 99%

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Reexamining Interstage Home Monitoring After the Norwood Operation

Pasquali

2015

Circulation

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Section: Article See P 502mentioning

confidence: 58%

Section: Article See P 502mentioning

confidence: 58%

Section: Article See P 502mentioning

confidence: 99%

Section: Article See P 502mentioning

confidence: 99%

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Reexamining Interstage Home Monitoring After the Norwood Operation

Pasquali

2015

Circulation

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“…For example, the National Pediatric Cardiology Quality Improvement Collaborative, involving 52 pediatric cardiac centers, achieved a 44% relative reduction in interstage mortality after hypoplastic left heart syndrome repair and acknowledged the importance of MOC as an incentive for participation in the collaborative. 27 Crandall et al 33 reported that the ImproveCareNow collaborative significantly increased remission rates for inflammatory bowel disease. ImproveCareNow was the prototype learning collaborative for MOC created by the ABP.…”

Section: The Impact Of Qi Activities For Which Moc Credit Is Awardedmentioning

confidence: 99%

Maintenance of Certification and the Challenge of Professionalism

Nichols

2017

Pediatrics

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Board certification has been part of the social contract in which physicians commit to maintaining up-to-date scientific knowledge and improving the quality of patient care. However, the maintenance of certification program has been controversial. This review summarizes the philosophical underpinnings, published literature, recent improvements, and future directions of the American Board of Pediatrics maintenance of certification program.

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Maintenance of Certification—A Prescription for Improved Child Health

2017

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When parents seek care for their children, they typically turn to general pediatricians and pediatric subspecialists for this care, recognizing that pediatricians have received specialized training tailored to children and adolescents. Parents generally trust pediatricians inherently and expect that these physicians will provide outstanding, state-of-the-art care on every encounter, keeping pace with the constantly evolving practice of pediatrics. To demonstrate to parents, hospitals, credentialing bodies, and payors evidence of the necessary background and expertise to provide state-of-the-art care, most pediatricians obtain board certification, a voluntary process that goes above and beyond state licensing requirements for practicing medicine and indicates an additional level of accomplishment and expertise. Hospitals increasingly require board certification for medical staff privileges, and credentialing bodies and payors often require board certification for participation in provider networks and for reimbursement.The process of board certification for general pediatricians and most pediatric subspecialists is administered by the American Board of Pediatrics (ABP) and requires completion of training in an accredited program, verification by the training program director of competence in 6 core competencies (patient care, medical knowledge, practice-based learning and improvement, professionalism, interpersonal and communication skills, and systems-based practice), and satisfactory performance on the ABP certifying examination in general pediatrics or the relevant pediatric subspecialty. For individuals who obtained initial certification in 1988 or afterward to remain certified, the ABP requires participation in Maintenance of Certification (MOC), a program that currently focuses on 3 of the core competencies, specifically professionalism, medical knowledge, and practice-based learning and improvement. Maintenance of certification is intended to demonstrate for the public those pediatricians who meet the highest standards of professionalism (part 1), lifelong learning and self-assessment (part 2), ongoing knowledge assessment (part 3), and improving professional practice (part 4).The process of MOC has received considerable attention in recent years, 1 raising questions among members of the pediatric community (and other medical specialties) about the objectives, format, time commitment, and impact relative to the cost to the diplomate. In response to feedback from pediatricians, the ABP has implemented major changes in the MOC program over the past few years, allowing MOC to continue to evolve. In particular, the ABP has attempted to clarify the goals of MOC, expand the range of options to satisfy MOC requirements, create options more applicable to a practi-VIEWPOINT

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Improvement in Interstage Survival in a National Pediatric Cardiology Learning Network

Abstract: ; Associates in Process Improvement, Austin, TX (L.P.); and The James M.

Cited by 142 publications

References 28 publications

Reexamining Interstage Home Monitoring After the Norwood Operation

Reexamining Interstage Home Monitoring After the Norwood Operation

Maintenance of Certification and the Challenge of Professionalism

Maintenance of Certification—A Prescription for Improved Child Health

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