Power of a Learning Network in Congenital Heart Disease. World J Pediatr Congenit Heart Surg 2019 Jan;10(1):66-71
Date
02/26/2019Pubmed ID
30799702DOI
10.1177/2150135118815023Scopus ID
2-s2.0-85062049776 (requires institutional sign-in at Scopus site) 32 CitationsAbstract
BACKGROUND: The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) formed to improve outcomes in infants with hypoplastic left heart syndrome. The collaborative sought to (1) decrease mortality, (2) reduce growth failure, and (3) reduce hospital readmissions due to major medical problems during the interstage period between discharge following stage 1 palliation (S1P) and admission for stage 2 palliation (S2P).
METHODS: The NPC-QIC is a learning network, coproduced by parents and clinicians, of 65 pediatric cardiology centers that contribute clinical data on care processes and outcomes to a shared registry. The adapted Breakthrough Series Model structure brings teams together regularly to review data, share lessons, and plan improvements. Outcomes are monitored using statistical process control methods.
RESULTS: Between 2008 and 2016, interstage mortality decreased by >40%, from 9.5% to 5.3%. Identification and use of a nutrition bundle led to improved infant growth, with a 28% reduction in interstage growth failure. The rate of serious hospital readmissions was low and did not significantly change. Importantly, a formed partnership with the parent group Sisters by Heart fostered the coproduction of tools and strategies and an emphasis on data transparency and outcomes.
CONCLUSIONS: The NPC-QIC's initial efforts led to improvements in interstage growth and mortality. The NPC-QIC has modeled the use of data for improvement and research, the value of coproduction with parents, and the concept "all teach, all learn," demonstrating the power of the learning network model.
Author List
Anderson JB, Brown DW, Lihn S, Mangeot C, Bates KE, Van Bergen AH, Rudd NA, Hanke S, Tweddell J, Lannon CAuthor
Nancy A. Rudd RN APP Inpatient 1 in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
CardiologyEducation, Medical, Graduate
Female
Heart Defects, Congenital
Humans
Infant
Infant, Newborn
Male
Norwood Procedures
Palliative Care
Quality Improvement
Registries
Retrospective Studies
Survival Rate
Treatment Outcome
United States
