Quality Measures for Congenital and Pediatric Cardiac Surgery

Abstract

This article presents 21 “Quality Measures for Congenital and Pediatric Cardiac Surgery” that were developed and approved by the Society of Thoracic Surgeons (STS) and endorsed by the Congenital Heart Surgeons’ Society (CHSS). These Quality Measures are organized according to Donabedian’s Triad of Structure, Process, and Outcome. It is hoped that these quality measures can aid in congenital and pediatric cardiac surgical quality assessment and quality improvement initiatives.

Outcomes Analysis and Quality Improvement for the Treatment of Patients with Pediatric and Congential Heart Disease

“…The STS Database is increasingly used to document variation in outcomes [29,30] and measure quality [31,32]; STS has collaborated with the Congenital Heart Surgeons' Society to develop and endorse metrics to assess the quality of care delivered to patients with pediatric and congenital cardiac disease [34]. Tables 4.3, 4.4, and 4.5 present 21 "quality measures for congenital and pediatric cardiac surgery" that were developed and approved by the Society of Thoracic Surgeons (STS) and endorsed by the Congenital Heart Surgeons' Society (CHSS).…”

“…Standardization of protocols for life-long follow-up [25][26][27][28] 7. Incorporation of strategies for quality assessment and quality improvement [29][30][31][32] Nomenclature Substantial effort has been devoted to the standardization of nomenclature and definitions related to surgery for pediatric and congenital cardiac disease. During the 1990s, both the European Association for Cardio-Thoracic Surgery (EACTS) and the Society of Thoracic Surgeons (STS) created databases to assess the outcomes of congenital cardiac surgery.…”

Újszülöttkorban és később végzett primer artériás switchműtétek eredményei egy újonnan létrehozott, átfogó congenitalis szívközpontban

“…Rövidítések ECMO = extracorporalis membránoxigenizáció, mesterséges keringés-és légzéstámogatás, "műszív-műtüdő"; IVS = (intact ventricular septum) ép kamrai sövény; MOF = (multi-organfailure) többszervi elégtelenség; n/a = nem alkalmazható; NEC = nekrotizáló enterocolitis; NS = nem szignifi káns; TGA = (transposition of the great arteries) nagyér-transzpozí-ció; TGA-IVS = (transposition of the great arteries -intact ventricular septum) nagyér-transzpozíció -ép kamrai sövény; TGA-VSD = (transposition of the great arteries -ventricular septal defect) nagyér-transzpozíció -kamrai sövényhiány Az újszülöttkori szívműtétek eredményei egy adott congenitalis szívsebészeti ellátás érzékeny indikátorai [1]. Újszülöttkorban számos (keringés, légzés, endokrin stb.)…”

Variation in Congenital Heart Surgery Costs Across Hospitals

“…These included the STS benchmark operations: ventricular septal defect (VSD) repair, Tetralogy of Fallot (TOF) repair (excluding pulmonary atresia or absent pulmonary valve, or atrioventricular canal repair), complete atrioventricular canal (CAVC) repair, arterial switch operation (ASO) +/2 VSD repair, Fontan operation (including lateral tunnel and extracardiac conduit +/2 fenestration; excluding Fontan revision), truncus arteriosus repair (excluding concomitant truncal valve repair/ replacement or interrupted aortic arch repair), and the Norwood operation (including either systemic-to-pulmonary artery shunt or right ventricle-topulmonary artery conduit). 13,14 In addition to these benchmark operations we also included atrial septal defect (ASD) repair and bidirectional Glenn (BDG)/hemi-Fontan. Of these 13 013 eligible patients, those who had missing data for any of the outcomes described below were excluded (n = 295 patients).…”

“…15 Both the occurrence of any postoperative complication collected in the STS-CHS Database, as well as major complications (as previously defined) were evaluated, including renal failure requiring dialysis, neurologic deficit persisting at discharge, arrhythmia requiring permanent pacemaker, mechanical circulatory support, phrenic nerve injury/paralyzed diaphragm, and unplanned reoperation/reintervention. 13,16 Center volume was collected and calculated as the average annual volume of cardiovascular operations (including all index cases with and without cardiopulmonary bypass) during the study period.…”