Giving New Meaning to Transparency

July 2016

​Outstanding Surgical Outcomes are Just a First Step

Treating more than 20,000 patients each year, The Heart Institute at Children’s Hospital Colorado is one of the largest programs of its kind in the country. It also delivers some of the best patient outcomes.

The Heart Institute reports its outcomes data to a number of national collaboratives and registries. One of the largest, the Society for Thoracic Surgeons (STS), compiles data for 117 pediatric cardiac surgery centers. The Heart Institute consistently has lower mortality and shorter lengths of hospital stay for complex surgeries when compared to the STS national average. 

(Pictured above: Cindy Barrett, MD, director of CHCO Heart Institute)

Yet the team at The Heart Institute isn’t content.  It remains committed to finding innovative ways to improve care. 

From Mortality to Quality of Life

Mortality used to be a primary measure of quality in pediatric cardiac care, but advancements in the last 10 years have shifted the focus to improving quality of life. 

Metrics associated with quality of life are nuanced, requiring everyone on their team to be dedicated to complete transparency. It’s this transparency that allows the team to take close, comprehensive review of how they care for patients and find ways to do better and continue to improve patient outcomes.

Cindy Barrett, MD, MPH​, has served as the institute’s director of safety and quality improvement since 2011. “The team’s relentless pursuit for excellence means we are continually striving to provide the best care for our patients and families,” she said. “Our approach to finding data-driven strategies to improve patient care locks arm in arm with Children’s Hospital Colorado’s overall approach. We review our own data continually to ensure we’re performing at the highest level possible.” 

For example, the team reviews the nutritional goals of children in and out of the hospital to ensure that the patients’ nutritional needs are being met. 

A current Heart Institute project is the development of an outpatient wellness program. This program will provide a holistic approach to care for children and families including nutritional, psychological and educational needs.  

Transparency 

In 2012, the team implemented weekly safety rounds. A physician and a nurse rotate through the different inpatient units asking open-ended questions about safety and quality of care. These conversations encourage families and team members to identify areas where patient care can be improved. Once a month the team is led by a parent to encourage families to speak to someone who has experienced caring for a child with heart disease about the care they are receiving. 

The Heart Institute’s commitment to transparency about outcomes has gained national attention. In 2015, CNN evaluated transparency​ of pediatric cardiac data by reviewing publically reported data from 107 centers. CNN based the level of center transparency on data reported to STS, overall volume, volume by procedure, number of surgeons, patient outcomes by procedure and surgical acuity. The Heart Institute was one of only three centers that fulfilled transparency criteria for patient volume and outcomes. 

CNN’s story highlighted what families should look for in pediatric cardiac care by demonstrating that outcomes vary from one center to another. 

“It’s a huge win for patients everywhere,” said Dr. Barrett.