To implement routine in-house monitoring of risk-adjusted 30-day mortality following paediatric cardiac surgery

Anderson, D

Banks, V

Brown, K

Crowe, S

McLean, A

Pagel, C

Samson, R

Tsang, V

Utley, M

Witter, T

PubMed

Christina Pagel

Martin Utley

Sonya Crowe

Thomas Witter

David Anderson

Ray Samson

Andrew McLean

Victoria Banks

Victor Tsang

Katherine Brown

Crossref

Heart

Real time monitoring of risk-adjusted paediatric cardiac surgery outcomes using variable life-adjusted display: implementation in three UK centres

Objective: To implement routine in-house monitoring of risk-adjusted 30-day mortality following paediatric cardiac surgery. Design: Collaborative monitoring software development and implementation in three specialist centres. Patients and methods: Analyses incorporated 2years of data routinely audited by the National Institute of Cardiac Outcomes Research (NICOR). Exclusion criteria were patients over 16 or undergoing non-cardiac or only catheter procedures. We applied the partial risk adjustment in surgery (PRAiS) risk model for death within 30days following surgery and generated variable life-adjusted display (VLAD) charts for each centre. These were shared with each clinical team and feedback was sought. Results: Participating centres were Great Ormond Street Hospital, Evelina Children's Hospital and The Royal Hospital for Sick Children in Glasgow. Data captured all procedures performed between 1 January 2010 and 31 December 2011. This incorporated 2490 30-day episodes of care, 66 of which were associated with a death within 30days.The VLAD charts generated for each centre displayed trends in outcomes benchmarked to recent national outcomes. All centres ended the 2-year period within four deaths from what would be expected. The VLAD charts were shared in multidisciplinary meetings and clinical teams reported that they were a useful addition to existing quality assurance initiatives. Each centre is continuing to use the prototype software to monitor their in-house surgical outcomes. Conclusions: Timely and routine monitoring of risk-adjusted mortality following paediatric cardiac surgery is feasible. Close liaison with hospital data managers as well as clinicians was crucial to the success of the project.</p

Pagel, Christina

Utley, Martin

Crowe, Sonya

Witter, Thomas

Anderson, David

Samson, Ray

McLean, Andrew

Banks, Victoria

Tsang, Victor

Brown, Katherine

King's Research Portal

Real time monitoring of risk-adjusted paediatric cardiac surgery outcomes using variable life-adjusted display:implementation in three UK centres

UCL Discovery

http://discovery.ucl.ac.uk/1390838/1/Heart-2013-Pagel-1445-50.pdf

Real time monitoring of risk-adjusted paediatric cardiac surgery outcomes using variable life-adjusted display: implementation in three UK centres

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King's Research Portal

UCL Discovery