Interhospital collaboration cuts pediatric heart condition-related deaths
The results of a new study suggest that transparent data sharing across 18 pediatric heart centers resulted in significant reductions in pediatric heart complication-related deaths and improved patient outcomes.
The results of a new study, conducted by researchers from Michigan Medicine (MI, USA), demonstrate that transparent data sharing across 18 pediatric heart centers significantly reduced perioperative pediatric heart complication-related deaths and improved patient outcomes.
A significant proportion of pediatric and congenital cardiovascular disease patients require surgery in infancy. These complex procedures can be associated with high postoperative mortality rates or complications.
In 2013, the Pediatric Cardiac Critical Care Consortium (PC4; MI, USA) was launched with the intention of improving the perioperative care delivered to intensive care unit babies by promoting expert collaboration and learning across hospitals.
The PC4 requires participant hospitals to share clinical outcome data through a registry; data can be submitted in real time and members have access to a web-based reporting platform, which is regularly updated.
In this study, researchers analyzed data pertaining to 19,600 hospitalizations at 18 participant institutions in the PC4 that included heart surgery. The outcomes of patients during a 2-year baseline period, following PC4 founding, were compared with those of all post-baseline months.
Researchers observed that in the months following baseline, postoperative mortality rates declined by 24%, incidences of major complications dropped by 12% and patients’ length of stay in intensive care units were reduced by 5%.
These same parameters were assessed across 17 additional, comparable hospitals, who were not PC4 members; no improvements in postoperative mortality rates, complications incidences or lengths of hospital stays were observed at these 17 institutions. The study authors note that these data strongly suggest that the significant improvements observed at PC4 member hospitals likely result from their PC4 participation and not simply a general trend of improvement across the wider field.
Michael Gaies, Founder of PC4 and Director of quality at the Congenital Heart Center at Michigan Medicine's C.S. Mott Children's Hospital (MI, USA), commented: “These changes in outcomes seem to reflect PC4's commitment to transparency between institutions and collaboration to share best practices. Hospitals are working together to create a culture of collaboration rather than competition. This work is having a tremendous impact on children and families battling critical heart disease.”
Gaies continued: “Institutions are sharing insight on practices and resources that underlie their excellent performance. We are seeing experts across the country committed to working together to improve the care of kids with congenital heart disease. This collaboration reveals the very best of people who care for these children and families.”
Gaies M, Pasquali SK, Banerjee M et al. Improvement in pediatric cardiac surgical outcomes through interhospital collaboration. J Am Coll Cardiol. doi:10.1016/j.jacc.2019.09.046 (2019) (Epub ahead of print);