International Quality Improvement Collaborative for Congenital Heart Surgery

1. International Quality Improvement Collaborative for Congenital Heart Surgery

2. Vision Facilitate a collaborative of healthcare teams from around the world creating a culture of patient safety & quality for children receiving congenital heart surgery in developing countries

3. Mission Our mission is to reduce mortality and major complications for children undergoing congenital heart surgery.

4. Objective Create tailored quality improvement strategies to reduce mortality and major complications for developing world programs. Employ a telemedicine platform to facilitate distance learning, dialogue, disseminate knowledge & skills.

5. Drivers of Mortality Team-based practice through nurse empowerment Reduce surgical site infections and bacterial sepsis Safe perioperative practices

6. Database Refresher November 18, 2010

7. Importance of Data • Standardized benchmarking data will identify drivers of mortality and life-threatening complications, as well as guide the development of targeted QI strategies. • Enable programs to evaluate performance, identify strengths and opportunities for improvement, and track progress over time. • Utilize for external comparative benchmarking to determine where programs stand in relation to their peers.

8. Outcome Measures • Primary Outcomes: • In-hospital and 30 day mortality • Risk adjustment based on RACHS-1 • Secondary Outcomes: • Blood stream infection/bacterial sepsis • Surgical site infection

9. RACHS-1 • Validated in multi-institutional data sets • Procedures are grouped into six risk categories • Additional clinical factors • Age group • Prematurity • Major non-cardiac structural anomaly

10. RACHS-1Risk Categories

11. Remote Data Capture • Diagnostic, procedural, and clinical data are entered into the database via a web-based tool. • Entering data remotely is easy and only requires an internet connection and standard web browser. • The database is maintained at Children’s Hospital Boston.

12. Data Capture Process • Data Entry • Query Process • Database Lock • Quarterly Reports

13. Data Entry • To gain access to the database or if you have problems with data entry contact: IQIC@childrens.harvard.edu

14. Query Process • Cleaning the data includes looking for missing data or other data-related issues. • Workbooks will be sent to collect missing data. • Please respond to data queries in a timely manner to prevent delays in submitting your data.

15. Database Lock • Database lock refers to the completion of data entry and resolution of queries as the database is locked and the report is then generated. • During the query process each quarter, you will have a deadline for completing data entry and a deadline to respond to all data queries.

16. Quarterly Reports • Each site will receive a confidential quarterly report including a summary of outcome data for their site. • All sites will receive an annual report including cumulative results of their data as well as cumulative results from all participating sites.

17. Data Capture Timeline

18. Using the Database

19. Data CRF & Entry Process

20. Home Page https://c3po.chcvp.org/INTL/

21. Logging In

22. Search Patient

23. CRF1 – Demographic Information

24. CRF2 – Pre-Operative Status

25. CRF3 – Patient Diagnosis

26. CRF4 – Surgical Procedure

27. CRF5 – Outcome/Complications

28. CRF6 – 30 Day Follow-Up

29. Webinar Recordings

30. Discussion Boards

31. Contact Us

32. Thank You