International quality improvement initiatives

Abstract

Across the globe, the implementation of quality improvement science and collaborative learning has positively affected the care and outcomes for children born with CHD. These efforts have advanced the collective expertise and performance of inter-professional healthcare teams. In this review, we highlight selected quality improvement initiatives and strategies impacting the field of cardiovascular care and describe implications for future practice and research. The continued leveraging of technology, commitment to data transparency, focus on team-based practice, and recognition of cultural norms and preferences ensure the success of sustainable models of global collaboration.

What are the important morbidities associated with paediatric cardiac surgery? A mixed methods study

“…Moreover, recent work on using graphical methods to routinely monitor a range of morbidities highlighted the complexity of graphically summarising multiple morbidities 28. The Pediatric Cardiac Critical Care Consortium (PC⁴) was set up in 2009, and provides partner sites with access to real-time, reliable and actionable data to be used for local quality improvements 29–32. However, membership of PC 4 is voluntary for institutions on a subscription basis, the reported measures been selected by clinicians, the reporting of outcomes is accessible only to subscribing member institutions and these are limited to in-hospital measures.…”

Rheumatic aortic valve disease—when and who to repair?

“…Need for specialized centers (10) Especially with valve repair, ensuring quality is an important consideration for surgical programs in limited-resource settings. Post-operative outcomes have been recorded in a robust manner for congenital heart disease surgery for children in these settings (17). The same practices could be easily extended to patients requiring rheumatic valve repair, since patient demographics and healthcare providers overlap significantly.…”

Pediatric Cardiac Intensive Care Society Statement: caring for children with critical cardiac disease across the globe

“…In addition, paediatric cardiac care has been supported to develop excellence by fostering inter-institutional partnerships, the examples of which -Jamaica, Mexico, India, and Viet Namare discussed in the Global Statement by Bastero et al 6 ; with the input of "missions" or visiting paediatric cardiac surgical trips, a detailed account of which is provided by Molloy et al 7 ; and in finding creative ways to care for critically ill children during transportation from one place to another, as discussed by Ramnarayam et al 8 Finally, a range of mechanisms have evolved to measure, monitor, and ultimately improve patient outcomes, this being a general principle that has very wide support within the PCICS organisation. As discussed in the article by Hickey et al, 9 these include the development of multi-institutional clinical databases to which centres can add patient data in order to compare their outcomes with those of others, the use of common and consistent methodologies to adjust for the severity of case mix, the identification of quality metrics to benchmark individual centre performance, and the fostering of a commitment to using improvement science methodologies.…”