Collaborative quality improvement in the congenital heart defects: development of the assist consortium and a preliminary surgical outcomes report
Rev. bras. cir. cardiovasc
; 32(4): 260-269, July-Aug. 2017. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-897919
Biblioteca responsável:
BR1.1
ABSTRACT
Abstract Objective:
ASSIST is the first Brazilian initiative in building a collaborative quality improvement program in pediatric cardiology and congenital heart disease. The purposes of this manuscript are (a) to describe the development of the ASSIST project, including the historical, philosophical, organizational, and infrastructural components that will facilitate collaborative quality improvement in congenital heart disease care; (b) to report past and ongoing challenges faced; and (c) to report the first preliminary data analysis.Methods:
A total of 614 operations were prospectively included in a comprehensive online database between September 2014 and December 2015 in two participating centers. Risk Adjustment for Congenital Heart Surgery (RACHS) 1 and Aristotle Basic Complexity (ABC) scores were obtained. Descriptive statistics were provided, and the predictive values of the two scores for mortality were calculated by multivariate logistic regression models.Results:
Many barriers and challenges were faced and overcome. Overall mortality was 13.4%. Independent predictors of in-hospital death were RACHS-1 categories (3, 4, and 5/6), ABC level 4, and age group (≤ 30 days, and 30 days - 1 year).Conclusion:
The ASSIST project was successfully created over a solid base of collaborative work. The main challenges faced, and overcome, were lack of institutional support, funding, computational infrastructure, dedicated staff, and trust. RACHS-1 and ABC scores performed well in our case mix. Our preliminary outcome analysis shows opportunities for improvement.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Avaliação de Processos e Resultados em Cuidados de Saúde
/
Melhoria de Qualidade
/
Cardiopatias Congênitas
Tipo de estudo:
Ensaio clínico controlado
/
Estudo de etiologia
/
Estudo de avaliação
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Aspecto:
Pesquisa de implementação
Limite:
Adolescente
/
Criança
/
Criança, pré-escolar
/
Feminino
/
Humanos
/
Lactente
/
Masculino
/
Recém-Nascido
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
CIRURGIA GERAL
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade de São Paulo/BR