title: Rationale and methodology of a collaborative learning project in congenital cardiac care.
abstract: BACKGROUND
  Collaborative learning is a technique through which individuals or teams learn together by capitalizing on one another's knowledge, skills, resources, experience, and ideas. Clinicians providing congenital cardiac care may benefit from collaborative learning given the complexity of the patient population and team approach to patient care.
  Industrial system engineers first performed broad-based time-motion and process analyses of congenital cardiac care programs at 5 Pediatric Heart Network core centers. Rotating multidisciplinary team site visits to each center were completed to facilitate deep learning and information exchange. Through monthly conference calls and an in-person meeting, we determined that duration of mechanical ventilation following infant cardiac surgery was one key variation that could impact a number of clinical outcomes. This was underscored by one participating center's practice of early extubation in the majority of its patients. A consensus clinical practice guideline using collaborative learning was developed and implemented by multidisciplinary teams from the same 5 centers. The 1-year prospective initiative was completed in May 2015, and data analysis is under way.
  
  
  CONCLUSIONS
  Collaborative learning that uses multidisciplinary team site visits and information sharing allows for rapid structured fact-finding and dissemination of expertise among institutions. System modeling and machine learning approaches objectively identify and prioritize focused areas for guideline development. The collaborative learning framework can potentially be applied to other components of congenital cardiac care and provide a complement to randomized clinical trials as a method to rapidly inform and improve the care of children with congenital heart disease.
authors.affiliation: Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA. Electronic address: wolfm@kidsheart.com.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wolf
authors.affiliation: School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA.
authors.forename: Eva K
authors.initials: EK
authors.lastname: Lee
authors.affiliation: Perelman School of Medicine at The University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Nicolson
authors.affiliation: National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Gail D
authors.initials: GD
authors.lastname: Pearson
authors.affiliation: University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, UT.
authors.forename: Madolin K
authors.initials: MK
authors.lastname: Witte
authors.affiliation: Children's Healthcare of Atlanta, Atlanta, GA.
authors.forename: Jeryl
authors.initials: J
authors.lastname: Huckaby
authors.affiliation: University of Michigan Medical School, CS Mott Children's Hospital, Ann Arbor, MI.
authors.forename: Michael
authors.initials: M
authors.lastname: Gaies
authors.affiliation: Baylor College of Medicine, Texas Children's Hospital, Houston, TX.
authors.forename: Lara S
authors.initials: LS
authors.lastname: Shekerdemian
authors.affiliation: Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA.
authors.forename: William T
authors.initials: WT
authors.lastname: Mahle
mesh_terms: D002309:Cardiology / Q000193:education*; D002648:Child; D003299:Cooperative Behavior; D006302:Health Services Research / Q000379:methods*; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D059032:Learning Curve; D010348:Patient Care Team