Skip to main content
SpringerLink
Log in

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)

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Bentham JR, Thomson JD (2015) Current state of interventional cardiology in congenital heart disease. Arch Dis Child 100:787–792. doi:10.1136/archdischild-2014-30605

    Article  CAS  PubMed  Google Scholar 

  2. Jayaram N, Beekman RH, Benson L, Holzer R, Jenkins K, Kennedy KF et al (2015) Adjusting for risk associated with pediatric and congenital cardiac catheterization: a report from the NCDR IMPACT registry. Circulation 132:1863–1870. doi:10.1161/CIRCULATIONAHA.114.014694

    PubMed  PubMed Central  Google Scholar 

  3. Chaudhry-waterman N, Coombsa S, Porras D, Holzer R et al (2014) Developing tools to measure quality in congenital catheterization and interventions: the congenital cardiac catheterization project on outcomes (C3PO). Methodist DeBakey Cardiovasc J 10:63–67

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bergersen L, Gauvreau K, Marshall A, Kreutzer J, Beekman R, Hirsch R et al (2011) Procedure-type risk categories for pediatric and congenital cardiac catheterization. Circ Cardiovasc Interv 4:188–194. doi:10.1161/CIRCINTERVENTIONS.110.959262

    Article  PubMed  Google Scholar 

  5. Bergersen L, Marshall A, Gauvreau K, Beekman R, Hirsch R, Foerster S et al (2010) Adverse event rates in congenital cardiac catheterization: a multi-center experience. Catheter Cardiovasc Interv 75:389–400. doi:10.1002/ccd.22266

    PubMed  Google Scholar 

  6. Bergersen L, Gauvreau K, Foerster SR, Marshall AC, McElhinney DB, Beekman RH et al (2011) Catheterization for congenital heart disease adjustment for risk method (CHARM). JACC Cardiovasc Interv 4:1037–1046. doi:10.1016/j.jcin.2011.05.021

    Article  PubMed  Google Scholar 

  7. Vincent RN, Moore J, Beekman RH, Benson L, Bergersen L, Holzer R et al (2016) Procedural characteristics and adverse events in diagnostic and interventional catheterisations in paediatric and adult CHD: initial report from the IMPACT Registry. Cardiol Young 26:70–78. doi:10.1017/S1047951114002637

    Article  PubMed  Google Scholar 

  8. Nykanen DG, Forbes TJ, Du W, Divekar AA, Reeves JH, Hagler DJ et al (2016) CRISP: catheterization RISK score for pediatrics: a report from the congenital cardiac interventional study consortium (CCISC). Catheter Cardiovasc Interv 87:302–309. doi:10.1002/ccd.26300

    Article  PubMed  Google Scholar 

  9. Ghelani SJ, Glatz AC, David S, Leahy R, Hirsch R, Armsby LB et al (2014) Radiation dose benchmarks during cardiac catheterization for congenital heart disease in the United States. JACC Cardiovasc Interv 7:1060–1069. doi:10.1016/j.jcin.2014.04.013

    Article  PubMed  Google Scholar 

  10. Institute for Healthcare Improvement (2003) The breakthrough series: IHI’s collaborative model for achieving breakthrough improvement. IHI Innovation Series white paper. http://www.ihi.org/resources/pages/ihiwhitepapers/thebreakthroughseriesihiscollaborativemodelforachievingbreakthroughimprovement.aspx. Accessed 7 March 2016

Download references

Acknowledgments

The authors would like to recognize the study coordinators and personnel that have made this project possible: Martin Bocks, MD, Cynthia Cardwell, Joanne Chisolm, Ron Grifka, MD, Rashi Gupta, Andrea Kennedy, Diane Kickbush, Tom Lloyd, MD, Karen Minsterman, Cyndi Murphy, Sharon Thomaston, and Suzanne Welch.

Author information

Authors and Affiliations

  1. Department of Cardiology, Boston Children’s Hospital, Bader 607, 300 Longwood Avenue, Boston, MA, 02115, USA

    Priscila C. Cevallos, Molly J. Rose & Lisa Bergersen

  2. Pediatric Cardiology Department, Doernbecher Children’s Hospital, Portland, OR, USA

    Laurie B. Armsby

  3. Department of Cardiology, Nationwide Children’s Hospital, Columbus, OH, USA

    Aimee K. Armstrong

  4. Department of Cardiology, Rady Children’s Hospital, San Diego, CA, USA

    Howaida EL-Said

  5. Division of Cardiology, Children’s Hospital of Wisconsin, Milwaukee, WI, USA

    Susan R. Foerster

  6. Cardiac Center, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Andrew C. Glatz

  7. Department of Cardiology, Cincinnati Children’s Hospital, Cincinnati, OH, USA

    Bryan H. Goldstein

  8. Division of Pediatric Cardiology, University of Virginia Medical Center, Charlottesville, VA, USA

    Michael R. Hainstock

  9. Division of Pediatric Cardiology, Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Jacqueline Kreutzer

  10. Department of Cardiology, Joe DiMaggio Children’s Hospital, Hollywood, FL, USA

    Larry A. Latson

  11. Department of Cardiology, Kosair Children’s Hospital, Louisville, KY, USA

    Ryan A. Leahy

  12. Department of Cardiology, Children’s Healthcare of Atlanta Sibley Heart Center, Atlanta, GA, USA

    Christopher J. Petit

  13. Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital, New York, NY, USA

    Alejandro Torres

  14. Division of Pediatric Cardiology, St. Louis Children’s Hospital, St. Louis, MO, USA

    Shabana Shahanavaz

  15. Department of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA

    Jeffrey D. Zampi

Authors
  1. Priscila C. Cevallos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Molly J. Rose
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laurie B. Armsby
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aimee K. Armstrong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Howaida EL-Said
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Susan R. Foerster
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Andrew C. Glatz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bryan H. Goldstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Michael R. Hainstock
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jacqueline Kreutzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Larry A. Latson
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Ryan A. Leahy
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Christopher J. Petit
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Alejandro Torres
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Shabana Shahanavaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Jeffrey D. Zampi
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Lisa Bergersen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa Bergersen.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cevallos, P.C., Rose, M.J., Armsby, L.B. et al. 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). Pediatr Cardiol 37, 1436–1445 (2016). https://doi.org/10.1007/s00246-016-1454-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-016-1454-z

Keywords

Search

Navigation