National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC)
Funded Annually by CHAoC
Primary Investigators: Jeffrey Anderson, MD and Carole Lannon, MD
Project Timeline: 2009-Present
The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) is a network of over 50 pediatric cardiology care centers across the United States and the District of Columbia. With our parent partner organization, Sisters by Heart, we work together with families, clinicians, researchers, and patients to dramatically improve the outcomes for children with cardiovascular disease/defects.
Mission
NPC-QIC is a pediatric research and quality improvement network with the mission to improve the outcomes of care for children with congenital heart disease/defects through a national collaborative network of providers and engaged parent partners.
Goals
The overarching goal of NPC-QIC is to improve outcomes for children with cardiovascular disease/defects. The initial project focused specifically on improving the survival and quality of life of infants with a univentricular heart during the “interstage” period following a Norwood operation (between their first and second heart surgeries). As these efforts in the interstage continue, the second phase of The Collaborative will also focus on care and outcomes of these infants from diagnosis through the child’s first year of life.
Approach
Harnessing the power of the collaborative learning network, NPC-QIC practices methodology aligned with the Model for Improvement (an improvement science method developed and endorsed by the Institute for Healthcare Improvement). It is with this approach that patients, clinicians, and researchers all work together to improve the outcomes of care for children with congenital heart disease/defects.
Additionally, an adapted Breakthrough Series Model is used, for engaging and working with cardiology teams throughout The Collaborative, to help teams learn from one another. This model promotes the use of rapid Plan-Do-Study-Act (PDSA) cycles where care teams address problems by testing interventions and subsequent modifications in small steps to achieve desired change.
Results
Since inception, NPC-QIC has developed and supported a robust national registry comprised of clinical process and outcome data on the care of infants in the “interstage” period. Using this data, The Collaborative has been able to engage pediatric cardiology programs across the nation and implement quality improvement strategies to standardize and improve care for these infants. We identified a growth bundle of several factors that contribute to improved growth during the interstage – a time period of particularly poor growth for these infants.
Importantly, the registry data documents a significant reduction in interstage mortality for infants cared for by teams participating in the collaborative.
Cumulative aggregate interstage mortality for these infants decreased from 9.5% to 5.1%, a relative reduction of 46%. We estimate this to be approximately 44 lives saved, or the equivalent of two classrooms of kindergartners. Performance on key process measures also improved. The Collaborative was able to conclude that this reduction in mortality was most likely related to improved reliability of key care processes (e.g. care transition and care coordination planning).
For additional results related to our progress, check out our official webpage (npcqic.org) where you will find the most up-to-date information.
