title: Collaborative quality improvement in the cardiac intensive care unit: development of the Paediatric Cardiac Critical Care Consortium (PC4).
abstract: Despite many advances in recent years for patients with critical paediatric and congenital cardiac disease, significant variation in outcomes remains across hospitals. Collaborative quality improvement has enhanced the quality and value of health care across specialties, partly by determining the reasons for variation and targeting strategies to reduce it. Developing an infrastructure for collaborative quality improvement in paediatric cardiac critical care holds promise for developing benchmarks of quality, to reduce preventable mortality and morbidity, optimise the long-term health of patients with critical congenital cardiovascular disease, and reduce unnecessary resource utilisation in the cardiac intensive care unit environment. The Pediatric Cardiac Critical Care Consortium (PC4) has been modelled after successful collaborative quality improvement initiatives, and is positioned to provide the data platform necessary to realise these objectives. We describe the development of PC4 including the philosophical, organisational, and infrastructural components that will facilitate collaborative quality improvement in paediatric cardiac critical care.
authors.affiliation: 1Department of Pediatrics and Communicable Diseases,Division of Cardiology,C.S. Mott Children's Hospital and University of Michigan Medical School,Ann Arbor,Michigan,United States of America.
authors.forename: Michael
authors.initials: M
authors.lastname: Gaies
authors.affiliation: 2Heart Institute,Cincinnati Children's Hospital Medical Center,Cincinnati,Ohio,United States of America.
authors.forename: David S
authors.initials: DS
authors.lastname: Cooper
authors.affiliation: 3Department of Pediatrics,Benioff Children's Hospital and University of California San Francisco School of Medicine,California,United States of America.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tabbutt
authors.affiliation: 4Department of Critical Care Medicine and Department of Paediatrics,The Labatt Family Heart Centre,The Hospital for Sick Children,University of Toronto School of Medicine,Toronto,Ontario,Canada.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Schwartz
authors.affiliation: 5Department of Pediatrics,Children's Hospital of Wisconsin,Medical College of Wisconsin,Milwaukee,Wisconsin,United States of America.
authors.forename: Nancy
authors.initials: N
authors.lastname: Ghanayem
authors.affiliation: 6Division of Pediatric Cardiology,Department of Pediatrics,Emory University School of Medicine/Children's Healthcare of Atlanta,Atlanta,Georgia,United States of America.
authors.forename: Nikhil K
authors.initials: NK
authors.lastname: Chanani
authors.affiliation: 7Ann & Robert H. Lurie Children's Hospital of Chicago,Northwestern University Feinberg School of Medicine,Chicago,Illinois,United States of America.
authors.forename: John M
authors.initials: JM
authors.lastname: Costello
authors.affiliation: 8Department of Cardiology,Boston Children's Hospital,Harvard Medical School,Boston,Massachusetts,United States of America.
authors.forename: Ravi R
authors.initials: RR
authors.lastname: Thiagarajan
authors.affiliation: 9Departments of Critical Care Medicine and Anaesthesia,The Hospital for Sick Children,University of Toronto School of Medicine,Toronto,Ontario,Canada.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Laussen
authors.affiliation: 10Department of Pediatrics,Section of Critical Care,Baylor College of Medicine,Texas Children's Hospital,Houston,Texas,United States of America.
authors.forename: Lara S
authors.initials: LS
authors.lastname: Shekerdemian
authors.affiliation: 11Michigan Congenital Heart Outcomes Research and Discovery (MCHORD) Unit,University of Michigan Congenital Heart Center,Ann Arbor,Michigan,United States of America.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Donohue
authors.affiliation: 11Michigan Congenital Heart Outcomes Research and Discovery (MCHORD) Unit,University of Michigan Congenital Heart Center,Ann Arbor,Michigan,United States of America.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Willis
authors.affiliation: 12Division of Pediatric Cardiac Surgery,Department of Surgery,The Cardiac Center,The Children's Hospital of Philadelphia,Perelman School of Medicine at the University of Pennsylvania,Philadelphia,Pennsylvania,United States of America.
authors.forename: J William
authors.initials: JW
authors.lastname: Gaynor
authors.affiliation: 13Department of Surgery,Division of Cardiac Surgery,Johns Hopkins University School of Medicine,Baltimore,Maryland,United States of America.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Jacobs
authors.affiliation: 14Section of Pediatric Cardiovascular Surgery,C.S. Mott Children's Hospital,University of Michigan Medical School,Ann Arbor,Michigan,United States of America.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Ohye
authors.affiliation: 1Department of Pediatrics and Communicable Diseases,Division of Cardiology,C.S. Mott Children's Hospital and University of Michigan Medical School,Ann Arbor,Michigan,United States of America.
authors.forename: John R
authors.initials: JR
authors.lastname: Charpie
authors.affiliation: 1Department of Pediatrics and Communicable Diseases,Division of Cardiology,C.S. Mott Children's Hospital and University of Michigan Medical School,Ann Arbor,Michigan,United States of America.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Pasquali
authors.affiliation: 15Department of Pediatrics,Division of Cardiology,Medical University of South Carolina,Charleston,South Carolina,United States of America.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Scheurer
mesh_terms: D006348:Cardiac Surgical Procedures / Q000592:standards*; D003299:Cooperative Behavior; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D010372:Pediatrics / Q000592:standards*; D058996:Quality Improvement / Q000458:organization & administration*; D012042:Registries; D014481:United States
keywords: Critical care; cardiac surgery; paediatric; quality improvement