Power of a Learning Network in Congenital Heart Disease.
World J Pediatr Congenit Heart Surg
; 10(1): 66-71, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30799702
ABSTRACT
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
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Cardiologia
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Sistema de Registros
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Educação de Pós-Graduação em Medicina
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Procedimentos de Norwood
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Melhoria de Qualidade
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Cardiopatias Congênitas
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Infant
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Male
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Newborn
País/Região como assunto:
America do norte
Idioma:
En
Revista:
World J Pediatr Congenit Heart Surg
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos