Transparency Leads to Better Outcomes
|James E. O'Brien Jr., MD,
Comparing outcomes between hospitals can be a sensitive subject. Patient acuity levels, program volumes and other factors make apples to apples comparisons difficult. There is also ample opportunity for misunderstanding among families seeking the best care for their children.
That is why many hospitals choose not to share their outcomes publicly. Children’s Mercy is not one of those hospitals.
Transparency and Our Commitment to Quality
As part of its ongoing commitment to quality, The Ward Family Heart Center at Children’s Mercy in Kansas City is making its outcomes transparent by publishing them on the hospital’s website.
"To be a leader, you have to be transparent about your outcomes," said James E. O’Brien Jr., MD, FACS, Division Chief, Cardiovascular Surgery and Co-Director of The Ward Family Heart Center. "Our outcomes are excellent. Through quality initiatives and program development, we are working to make them even better. Because of the level of complexity within the cases we see, sometimes our outcomes won’t be great, but we will continue to share our data."
Long-term neurodevelopment – the new standard for outcomes
The standard outcome measurement for cardiac surgery has been survival based on risk stratification as reported to the Society of Thoracic Surgeons database. Now that the vast majority of children survive congenital heart operations, outcomes measurement at Children’s Mercy is moving beyond survival to look at quality of life and neurodevelopmental outcomes.
"Even though mortality is the quality marker that’s out there, we’re realizing that just tracking mortality is not going to be discriminatory enough. We need to do a better job," says Dr. O’Brien. "We have to provide the best quality of life possible for these patients. So we’re starting to evaluate treatments and procedures to ensure they lead to the highest quality of life for these kids as they get older."
Using Data and Long-Term Outcome Measurements
Millions of surgeries and lab results are used to treat each patient.
The Center’s patented HeartCenter software plays a critical role in providing new outcomes measurements. With a decade’s worth of data on more than 5,000 surgeries and millions of lab results, the database is an invaluable repository of information for conducting research, improving the quality of patient care and increasing departmental productivity.
"We collect literally tens of thousands of pieces of data on every patient that comes through here," says Dr. O’Brien. “By tracking all of the clinical variables associated with our large number of patients, we’re able to evaluate what’s working well. The ability to analyze all of this data gives us the ability to optimize processes and treatments."
Data and long-term outcome measurements are driving factors behind the Center’s development of a neurodevelopmental outcomes clinic. Plans call for all complex patients to periodically visit the clinic for neurocognitive testing and other evaluations to see how they are progressing in the years following their procedures. Allied health services will also be available.
Tracking Procedure Outcomes
Dr. O’Brien notes that the Center is looking at specific procedure outcomes as well.
"For example, we can look at the evaluation of a specific operation over years, all the various tests patients had, the evaluations of their heart function, heart rhythm, exercise, and how they are doing in school. That will help us optimize our procedures," says Dr. O’Brien.
The ability to implement these new measures is based on The Ward Family Heart Center’s integrated administrative structure. Cardiac surgery, cardiology, anesthesiologists, critical care physicians and nurses function as one team, providing a collaborative
approach to care for patients.
"I believe the story behind our numbers and better outcomes is directly linked to our collaborative approach to taking care of patients,” Dr. O’Brien says. "No matter the service, our group of experts is working as a team to provide the best possible outcomes. We
are constantly gathering data, studying our outcomes and improving our strategies to provide the highest quality of cardiac care for all our young patients; and to help ensure they have excellent high quality of life as they grow older."