Alternative approach to pediatric cardiac quality assessment for low‐volume centers

Abstract

Background In pediatric cardiac care, many centers participate in multiple, national, domain‐specific registries, as a major component of their quality assessment and improvement efforts. Small cardiac programs, whose clinical activities and scale may not be well‐suited to this approach, need alternative methods to assess and track quality. Methods We conceived of and piloted a rapid‐approach cardiac quality assessment, intended to encompass multiple aspects of the service line, in a low‐volume program. The assessment incorporated previously identified measures, drawn from multiple sources, and ultimately relied on retrospective chart review. Results A collaborative, multidisciplinary team formed and came to consensus on quality metrics pertaining to 3 chosen areas of clinical activity in the program. Despite the use of multiple different data sources and the need for manual chart review in data collection, a rich assessment of these program components was completed for presentation in 6 weeks. Conclusions While small programs may not participate in the spectrum of cardiac care registries available, these same centers can benefit from them by adapting some of their validated metrics for use in internal, self‐maintained quality reports. Our pilot of this alternative approach revealed opportunities for improved quality assessment practices; the product can serve as a baseline for future prospective assessment and reporting, as well as longitudinal internal benchmarking.

Approaches to enabling rapid evaluation of innovations in health and social care: a scoping review of evidence from high-income countries

“… 138 158 161 In other cases, no such measures were reported; such studies accepted—explicitly or implicitly—the trade-off between rapidity and representativeness or reliability of research. 159 An alternative approach involved using a less-intensive method resulting in reduced information collected for each participant or site. This included using a briefer form of a research tool (survey, questionnaire or interview proforma).…”

Rapid Evaluations of Innovations: A Scoping Review

“…Some studies balanced the impact of using smaller samples by employing techniques identi ed in methods designed speci cally for rapid evaluation above, such as stating that they used random or pseudo-random participant/site selection, or selected participants to ensure representativeness (44,(50)(51)(52). In other cases no such measures were reported; such studies acceptedexplicitly or implicitly -the trade-off between rapidity and representativeness or reliability of research (53). An alternative approach involved using a less-intensive method resulting in reduced information collected for each participant or site.…”

Rapid Evaluations of Innovations: A Scoping Review

“…The second approach to rapid evaluation involved undertaking evaluation on a smaller scale or in a lessintensive way (Table 3); sometimes with overlap with use of an alternative technology (see section 4 below) (44,86). We identi ed 13 studies of this type (44,45,68,(82)(83)(84)(85)(86)(88)(89)(90)(91)(92).…”

“…Some studies balanced the impact of using smaller samples by employing techniques identi ed in methods designed speci cally for rapid evaluation above, such as stating that they used random or pseudo-random participant/site selection, or selected a subsample of participants in such a way to ensure representativeness (86,91,117,118). In other cases, no such measures were reported; such studies accepted -explicitly or implicitly -the trade-off between rapidity and representativeness or reliability of research (92). An alternative approach involved using a less-intensive method resulting in reduced information collected for each participant or site.…”