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Abstract 11797: Evaluation of Progress Made in a Learning Network by Early Performance Level

IntroductionThe National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) is a learning network that has demonstrated a reduction in interstage mortality and growth failure after stage 1 palliation for hypoplastic left heart syndrome and variants. It remains unclear which centers hav...

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Published in:Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A11797-A11797
Main Authors: Hill, Garick D, Bingler, Michael, McCoy, Allison B, Oster, Matt, Pitcher, Taylor, Uzark, Karen, Bates, Katherine E
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container_issue Suppl_1 Suppl 1
container_start_page A11797
container_title Circulation (New York, N.Y.)
container_volume 138
creator Hill, Garick D
Bingler, Michael
McCoy, Allison B
Oster, Matt
Pitcher, Taylor
Uzark, Karen
Bates, Katherine E
description IntroductionThe National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) is a learning network that has demonstrated a reduction in interstage mortality and growth failure after stage 1 palliation for hypoplastic left heart syndrome and variants. It remains unclear which centers have contributed to these reductions. We sought to compare center-level outcomes based on early performance level for participants in the NPC-QIC.MethodsNPC-QIC centers with ≥10 patients in the early time period (1/2008-6/2013) were divided into tertiles based on early performance for mortality and separately for growth. These groups were evaluated for improvement from the early to late (7/2013-8/2016) time period and compared with the other groups in the late time period.ResultsMortality was 13/346 (3.8%), 22/290 (7.6%) and 34/236 (14.4%) for the high, medium and low-performing groups, respectively, in the early period. Growth failure occurred in 37/266 (13.9%), 69/315 (21.9%) and 66/201 (32.8%) for the high, medium and low-performing groups, respectively, in the early period. The high and medium-performing groups showed no significant change in mortality or growth failure between periods while the low-performing group had a significant decrease in mortality (14.4% to 4.5%, p
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fullrecord <record><control><sourceid>wolterskluwer</sourceid><recordid>TN_cdi_wolterskluwer_health_00003017-201811061-00686</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>00003017-201811061-00686</sourcerecordid><originalsourceid>FETCH-wolterskluwer_health_00003017-201811061-006863</originalsourceid><addsrcrecordid>eNqdjsGKwjAURYOMYEf9h_cDgaRpG-tuGCounMHFLAfkqa9ajQm8RIt_bxfzBbM6XDgXzkhkuswLWZSmfhOZUqqW1uT5RLzHeBlmZWyZid-PfUyMhwRa29ouoXmgu2PqgofQwpbDiSlG-MIjQecBYUPIvvMn-KbUB77C_gkNsnvClrgNfEN_oMF6kJuJcYsu0vyPU1Gsmp_PteyDS8Tx6u498e5M6NJ5NzQpo7SVudILrVWl5VC5qMw_by__uEqc</addsrcrecordid><sourcetype>Publisher</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Abstract 11797: Evaluation of Progress Made in a Learning Network by Early Performance Level</title><source>EZB Electronic Journals Library</source><creator>Hill, Garick D ; Bingler, Michael ; McCoy, Allison B ; Oster, Matt ; Pitcher, Taylor ; Uzark, Karen ; Bates, Katherine E</creator><creatorcontrib>Hill, Garick D ; Bingler, Michael ; McCoy, Allison B ; Oster, Matt ; Pitcher, Taylor ; Uzark, Karen ; Bates, Katherine E</creatorcontrib><description>IntroductionThe National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) is a learning network that has demonstrated a reduction in interstage mortality and growth failure after stage 1 palliation for hypoplastic left heart syndrome and variants. It remains unclear which centers have contributed to these reductions. We sought to compare center-level outcomes based on early performance level for participants in the NPC-QIC.MethodsNPC-QIC centers with ≥10 patients in the early time period (1/2008-6/2013) were divided into tertiles based on early performance for mortality and separately for growth. These groups were evaluated for improvement from the early to late (7/2013-8/2016) time period and compared with the other groups in the late time period.ResultsMortality was 13/346 (3.8%), 22/290 (7.6%) and 34/236 (14.4%) for the high, medium and low-performing groups, respectively, in the early period. Growth failure occurred in 37/266 (13.9%), 69/315 (21.9%) and 66/201 (32.8%) for the high, medium and low-performing groups, respectively, in the early period. The high and medium-performing groups showed no significant change in mortality or growth failure between periods while the low-performing group had a significant decrease in mortality (14.4% to 4.5%, p&lt;0.001) and growth failure (32.8% to 13.5%, p&lt;0.001) from the early to late period (Figures 1A and 1B). In the late period, there was no difference in mortality across the high (21/366, 5.7%), medium (18/257, 7.0%) and low (11/231, 4.8%) performing centers (p=0.5) with a trend towards a significant difference in growth failure between the high (48/243, 19.8%), medium (63/293, 21.5%) and low (31/230, 13.5%) performing groups (p=0.054).ConclusionsThe improvement seen in the NPC-QIC mortality and growth measures is primarily driven by those performing the worst in these areas initially. Rapid and dramatic improvement in low-performing centers is possible through a learning network.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><language>eng</language><publisher>by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><ispartof>Circulation (New York, N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A11797-A11797</ispartof><rights>2018 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids></links><search><creatorcontrib>Hill, Garick D</creatorcontrib><creatorcontrib>Bingler, Michael</creatorcontrib><creatorcontrib>McCoy, Allison B</creatorcontrib><creatorcontrib>Oster, Matt</creatorcontrib><creatorcontrib>Pitcher, Taylor</creatorcontrib><creatorcontrib>Uzark, Karen</creatorcontrib><creatorcontrib>Bates, Katherine E</creatorcontrib><title>Abstract 11797: Evaluation of Progress Made in a Learning Network by Early Performance Level</title><title>Circulation (New York, N.Y.)</title><description>IntroductionThe National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) is a learning network that has demonstrated a reduction in interstage mortality and growth failure after stage 1 palliation for hypoplastic left heart syndrome and variants. It remains unclear which centers have contributed to these reductions. We sought to compare center-level outcomes based on early performance level for participants in the NPC-QIC.MethodsNPC-QIC centers with ≥10 patients in the early time period (1/2008-6/2013) were divided into tertiles based on early performance for mortality and separately for growth. These groups were evaluated for improvement from the early to late (7/2013-8/2016) time period and compared with the other groups in the late time period.ResultsMortality was 13/346 (3.8%), 22/290 (7.6%) and 34/236 (14.4%) for the high, medium and low-performing groups, respectively, in the early period. Growth failure occurred in 37/266 (13.9%), 69/315 (21.9%) and 66/201 (32.8%) for the high, medium and low-performing groups, respectively, in the early period. The high and medium-performing groups showed no significant change in mortality or growth failure between periods while the low-performing group had a significant decrease in mortality (14.4% to 4.5%, p&lt;0.001) and growth failure (32.8% to 13.5%, p&lt;0.001) from the early to late period (Figures 1A and 1B). In the late period, there was no difference in mortality across the high (21/366, 5.7%), medium (18/257, 7.0%) and low (11/231, 4.8%) performing centers (p=0.5) with a trend towards a significant difference in growth failure between the high (48/243, 19.8%), medium (63/293, 21.5%) and low (31/230, 13.5%) performing groups (p=0.054).ConclusionsThe improvement seen in the NPC-QIC mortality and growth measures is primarily driven by those performing the worst in these areas initially. Rapid and dramatic improvement in low-performing centers is possible through a learning network.</description><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNqdjsGKwjAURYOMYEf9h_cDgaRpG-tuGCounMHFLAfkqa9ajQm8RIt_bxfzBbM6XDgXzkhkuswLWZSmfhOZUqqW1uT5RLzHeBlmZWyZid-PfUyMhwRa29ouoXmgu2PqgofQwpbDiSlG-MIjQecBYUPIvvMn-KbUB77C_gkNsnvClrgNfEN_oMF6kJuJcYsu0vyPU1Gsmp_PteyDS8Tx6u498e5M6NJ5NzQpo7SVudILrVWl5VC5qMw_by__uEqc</recordid><startdate>20181106</startdate><enddate>20181106</enddate><creator>Hill, Garick D</creator><creator>Bingler, Michael</creator><creator>McCoy, Allison B</creator><creator>Oster, Matt</creator><creator>Pitcher, Taylor</creator><creator>Uzark, Karen</creator><creator>Bates, Katherine E</creator><general>by the American College of Cardiology Foundation and the American Heart Association, Inc</general><scope/></search><sort><creationdate>20181106</creationdate><title>Abstract 11797: Evaluation of Progress Made in a Learning Network by Early Performance Level</title><author>Hill, Garick D ; Bingler, Michael ; McCoy, Allison B ; Oster, Matt ; Pitcher, Taylor ; Uzark, Karen ; Bates, Katherine E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-wolterskluwer_health_00003017-201811061-006863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Hill, Garick D</creatorcontrib><creatorcontrib>Bingler, Michael</creatorcontrib><creatorcontrib>McCoy, Allison B</creatorcontrib><creatorcontrib>Oster, Matt</creatorcontrib><creatorcontrib>Pitcher, Taylor</creatorcontrib><creatorcontrib>Uzark, Karen</creatorcontrib><creatorcontrib>Bates, Katherine E</creatorcontrib><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hill, Garick D</au><au>Bingler, Michael</au><au>McCoy, Allison B</au><au>Oster, Matt</au><au>Pitcher, Taylor</au><au>Uzark, Karen</au><au>Bates, Katherine E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abstract 11797: Evaluation of Progress Made in a Learning Network by Early Performance Level</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><date>2018-11-06</date><risdate>2018</risdate><volume>138</volume><issue>Suppl_1 Suppl 1</issue><spage>A11797</spage><epage>A11797</epage><pages>A11797-A11797</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><abstract>IntroductionThe National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) is a learning network that has demonstrated a reduction in interstage mortality and growth failure after stage 1 palliation for hypoplastic left heart syndrome and variants. It remains unclear which centers have contributed to these reductions. We sought to compare center-level outcomes based on early performance level for participants in the NPC-QIC.MethodsNPC-QIC centers with ≥10 patients in the early time period (1/2008-6/2013) were divided into tertiles based on early performance for mortality and separately for growth. These groups were evaluated for improvement from the early to late (7/2013-8/2016) time period and compared with the other groups in the late time period.ResultsMortality was 13/346 (3.8%), 22/290 (7.6%) and 34/236 (14.4%) for the high, medium and low-performing groups, respectively, in the early period. Growth failure occurred in 37/266 (13.9%), 69/315 (21.9%) and 66/201 (32.8%) for the high, medium and low-performing groups, respectively, in the early period. The high and medium-performing groups showed no significant change in mortality or growth failure between periods while the low-performing group had a significant decrease in mortality (14.4% to 4.5%, p&lt;0.001) and growth failure (32.8% to 13.5%, p&lt;0.001) from the early to late period (Figures 1A and 1B). In the late period, there was no difference in mortality across the high (21/366, 5.7%), medium (18/257, 7.0%) and low (11/231, 4.8%) performing centers (p=0.5) with a trend towards a significant difference in growth failure between the high (48/243, 19.8%), medium (63/293, 21.5%) and low (31/230, 13.5%) performing groups (p=0.054).ConclusionsThe improvement seen in the NPC-QIC mortality and growth measures is primarily driven by those performing the worst in these areas initially. Rapid and dramatic improvement in low-performing centers is possible through a learning network.</abstract><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub></addata></record>
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title Abstract 11797: Evaluation of Progress Made in a Learning Network by Early Performance Level
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