title: Implementation of Methodology for Quality Improvement in Pediatric Cardiac Catheterization: A Multi-center Initiative by the Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI).
abstract: The Congenital Cardiac Catheterization Project on Outcomes (C3PO) launched in 2007 as a multi-center collaborative to establish standardized and comparable metrics for pediatric cardiac catheterization procedures. The limitations of larger registries at the time led to the development of the next phase in 2013, C3PO-Quality Improvement (C3PO-QI), focusing on instituting QI initiatives within the field. The objective of this manuscript is to provide a detailed overview of C3PO-QI and report data on case characteristics and outcome metrics being explored. C3PO-QI was designed to cultivate institutional collaboration during implementation of its initiatives. A database and website were developed to support data entry and on-demand reporting. The registry prospectively captures pediatric cardiac catheterization data among 15 hospitals. The present study includes case demographic data (n) and quality metric reporting by case type, age, and radiation dose variables. This dataset includes 13,135 cases entered into the database between 1/1/2014 and 12/31/2015. Interventional cases make up the highest percentage by case mix distribution (48 %), and patients <1 years make up the highest percentage by age distribution (26 %). The ratio of diagnostic and interventional procedures performed changes by age group. Application of QI metric shows all procedure types surpassing metric goals. Large volume data collection, such as in C3PO-QI, allows for meaningful interpretation of data. C3PO-QI is uniquely poised to deliver fast-paced changes in the field. Although the project initiatives are specific to pediatric cardiac catheterization, the implementation of the project and utilization of real-time reporting is generalizable to other specialties and multi-center collaboratives.
authors: Department of Cardiology, Boston Children's Hospital, Bader 607, 300 Longwood Avenue, Boston, MA, 02115, USA.
authors: Priscila C
authors: http://orcid.org/0000-0003-0961-7560
authors: PC
authors: Cevallos
authors: Department of Cardiology, Boston Children's Hospital, Bader 607, 300 Longwood Avenue, Boston, MA, 02115, USA.
authors: Molly J
authors: MJ
authors: Rose
authors: Pediatric Cardiology Department, Doernbecher Children's Hospital, Portland, OR, USA.
authors: Laurie B
authors: LB
authors: Armsby
authors: Department of Cardiology, Nationwide Children's Hospital, Columbus, OH, USA.
authors: Aimee K
authors: AK
authors: Armstrong
authors: Department of Cardiology, Rady Children's Hospital, San Diego, CA, USA.
authors: Howaida
authors: H
authors: El-Said
authors: Division of Cardiology, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
authors: Susan R
authors: SR
authors: Foerster
authors: Cardiac Center, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors: Andrew C
authors: AC
authors: Glatz
authors: Department of Cardiology, Cincinnati Children's Hospital, Cincinnati, OH, USA.
authors: Bryan H
authors: BH
authors: Goldstein
authors: Division of Pediatric Cardiology, University of Virginia Medical Center, Charlottesville, VA, USA.
authors: Michael R
authors: MR
authors: Hainstock
authors: Division of Pediatric Cardiology, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
authors: Jacqueline
authors: J
authors: Kreutzer
authors: Department of Cardiology, Joe DiMaggio Children's Hospital, Hollywood, FL, USA.
authors: Larry A
authors: LA
authors: Latson
authors: Department of Cardiology, Kosair Children's Hospital, Louisville, KY, USA.
authors: Ryan A
authors: RA
authors: Leahy
authors: Department of Cardiology, Children's Healthcare of Atlanta Sibley Heart Center, Atlanta, GA, USA.
authors: Christopher J
authors: CJ
authors: Petit
authors: Division of Pediatric Cardiology, Morgan Stanley Children's Hospital, New York, NY, USA.
authors: Alejandro
authors: A
authors: Torres
authors: Division of Pediatric Cardiology, St. Louis Children's Hospital, St. Louis, MO, USA.
authors: Shabana
authors: S
authors: Shahanavaz
authors: Department of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA.
authors: Jeffrey D
authors: JD
authors: Zampi
authors: Department of Cardiology, Boston Children's Hospital, Bader 607, 300 Longwood Avenue, Boston, MA, 02115, USA. lisa.bergersen@cardio.chboston.org.
authors: Lisa
authors: L
authors: Bergersen
mesh_terms: D006328:Cardiac Catheterization; D002648:Child; D016208:Databases, Factual; D006330:Heart Defects, Congenital; D006801:Humans; D058996:Quality Improvement; D012042:Registries
keywords: Catheterization; Congenital heart disease; Multi-center initiative; Pediatric cardiology; Quality improvement