Impact of the International Quality Improvement Collaborative on outcomes after congenital heart surgery: A single center experience in a developing economy.
Ann Card Anaesth
;
2015 Jan-Mar ; 18(1): 52-57
Article
in English
| IMSEAR
| ID: sea-156502
ABSTRACT
Background:
The International Quality Improvement Collaborative (IQIC) for Congenital Heart Surgery in Developing Countries was initiated to decrease mortality and major complications after congenital heart surgery in the developing world.Objective:
We sought to assess the impact of IQIC on postoperative outcomes after congenital heart surgery at our institution.Methods:
The key components of the IQIC program included creation of a robust worldwide database on key outcome measures and nurse education on quality driven best practices using telemedicine platforms. We evaluated 1702 consecutive patients ≤18 years undergoing congenital heart surgery in our institute from January 2010-December 2012 using the IQIC database. Preoperative variables included age, gender, weight at surgery and surgical complexity as per the RACHS-1 model. The outcome variables included, in- hospital mortality, duration of ventilation, intensive care unit (ICU) stay, bacterial sepsis and surgical site infection.Results:
The 1702 patients included 771(45.3%) females. The median age was 8 months (0.03-216) and the median weight was 6.1Kg (1-100). The overall in-‑hospital mortality was 3.1%, Over the three years there was a significant decline in bacterial sepsis (from 15.1%, to 9.6%, P < 0.001), surgical site infection (11.1% to 2.4%, P < 0.001) and duration of ICU stay from 114(8-999) hours to 72 (18-999) hours (P < 0.001) The decline in mortality from (4.3% to 2.2%) did not reach statistical significance.Conclusions:
The inclusion of our institution in the IQIC program was associated with improvement in key outcome measures following congenital heart surgery over a three year period.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Thoracic Surgery
/
Treatment Outcome
/
Developing Countries
/
Quality Improvement
/
Heart Defects, Congenital
/
Heart Diseases
/
Cardiac Surgical Procedures
Type of study:
Practice guideline
/
Health economic evaluation
/
Prognostic study
Language:
English
Journal:
Ann Card Anaesth
Year:
2015
Type:
Article
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