Improved National Outcomes Achieved in a Cardiac Learning Health Collaborative Based on Early Performance Level - 27/01/21
, Michael Bingler, MD 3, Allison B. McCoy, PhD 4, Matthew E. Oster, MD, MPH 5, 6, Karen Uzark, PhD 7, 8, Katherine E. Bates, MD, MSHP 7Abstract |
Objective |
Within the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC), a learning health network developed to improve outcomes for patients with hypoplastic left heart syndrome and variants, we assessed which centers contributed to reductions in mortality and growth failure.
Study design |
Centers within the NPC-QIC were divided into tertiles based on early performance for mortality and separately for growth failure. These groups were evaluated for improvement from the early to late time period and compared with the other groups in the late time period.
Results |
Mortality was 3.8% for the high-performing, 7.6% for the medium-performing, and 14.4% for the low-performing groups in the early time period. Only the low-performing group had a significant change (P < .001) from the early to late period. In the late period, there was no difference in mortality between the high- (5.7%), medium- (7%), and low- (4.6%) performing centers (P = .5). Growth failure occurred in 13.9% for the high-performing, 21.9% for the medium-performing, and 32.8% for the low-performing groups in the early time period. Only the low-performing group had a significant change (P < .001) over time. In the late period, there was no significant difference in growth failure between the high- (19.8%), medium- (21.5%), and low- (13.5%) performing groups (P = .054).
Conclusions |
Improvements in the NPC-QIC mortality and growth measures are primarily driven by improvement in those performing the worst in these areas initially without compromising the success of high-performing centers. Focus for improvement may vary by center based on performance.
Le texte complet de cet article est disponible en PDF.Keywords : single ventricle, quality improvement
Abbreviations : LHN, NPC-QIC, RV-PA
Plan
| Supported by the National Center for Advancing Translational Sciences, National Institutes of Health (8UL1TR000055). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest. |
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| Portions of this study were presented at the AHA Scientific Sessions, November 10, 2018, Chicago, Illonois. |
Vol 222
P. 186 - juillet 2020 Retour au numéro
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