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Experience participating in the American College of Cardiology Quality NetworkTM: paediatric and adult congenital cardiology collaborative quality improvement

Published online by Cambridge University Press:  30 October 2018

Lauren P. Hartwell Open the ORCID record for Lauren P. Hartwell [Opens in a new window] ,
Annette L. Baker ,
Kathy J. Jenkins ,
Sarah D. de Ferranti  and
Susan F. Saleeb
Lauren P. Hartwell
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
Annette L. Baker
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
Kathy J. Jenkins
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
Sarah D. de Ferranti
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
Susan F. Saleeb*
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
*
Author for correspondence: S. F. Saleeb, MD, Department of Cardiology, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, USA. Tel: +1-617-355-4890; Fax: +617-739-6282; E-mail: susan.saleeb@cardio.chboston.org
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Abstract

Background

The American College of Cardiology Quality Network enables national benchmarking and collaborative quality improvement through vetted metrics. We describe here our initial experience with the Quality Network.

Methods

Quarterly data for metrics pertaining to chest pain, Kawasaki disease, tetralogy of Fallot, elevated body mass index, and others were shared with the collaboratives for benchmarking. National improvement efforts focussed on counselling for elevated body mass index and 22q11.2 testing in tetralogy of Fallot. Improvement strategies included developing multi-disciplinary workgroups, educational materials, and electronic health record advances.

Results

Chest pain metric performance was high compared with national means: obtaining family history (90–100% versus 51–77%), electrocardiogram (100% versus 89–99%), and echocardiogram for exertional complaints (95–100% versus 74–96%). Kawasaki metric performance was high, including obtaining coronary measurements (100% versus 85–97%), prescribing aspirin (100% versus 86–99%), follow-up with imaging (100% versus 85–98%), and documenting no activity restriction without coronary aneurysms (83–100% versus 64–93%). Counselling for elevated body mass index was variable (25–75% versus 31–50%) throughout quality improvement efforts. Testing for 22q11.2 deletion in tetralogy of Fallot patients was consistently above the national mean (60–85% versus 54–68%) with improved genetics data capture.

Conclusion

The Quality Network promotes meaningful benchmarking and collaborative quality improvement. Our high performance for chest pain and Kawasaki metrics is likely related to previous improvement efforts in chest pain management and a dedicated Kawasaki team. Uptake of counselling for elevated body mass index is variable; stronger engagement among numerous providers is needed. Recommendations for 22q11.2 testing in tetralogy of Fallot were widely recognised and implemented.

Keywords

CHDquality improvementQuality Network
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 1 , January 2019 , pp. 59 - 66
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Hartwell LP, Baker AL, Jenkins KJ, de Ferranti SD, Saleeb SF. (2018). Experience participating in the American College of Cardiology Quality NetworkTM: paediatric and adult congenital cardiology collaborative quality improvement. Cardiology in the Young29: 59–66. doi: 10.1017/S104795111800183X

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