According to published estimates, about one in 110 babies in the United States is born with congenital heart disease. On the surface, the incidence of the disease is relatively low, but the consequences can be profound. New, rapidly evolving interventional treatments are extending lives and enhancing the quality of life for children living with congenital heart disease. These advancements are driving a need for quality tools that are specific to pediatric interventional cardiology.
In 2014, the Society for Cardiovascular Angiography and Interventions (SCAI) unveiled a new resource that is designed to help pediatric cardiac catheterization laboratories continuously improve care. The resource—called the Pediatric SCAI Quality Improvement Toolkit, or Pediatric SCAI-QIT—provides clinicians with a comprehensive toolkit that complements the adult SCAI-QIT for catheterization laboratories. Introduced by SCAI in 2011, the adult SCAI-QIT features regular updates on continuous quality improvement, accreditation, peer reviews, measurement, public reporting, and patient and physician education.
Fulfilling a Need
“Pediatric quality improvement requires specific tools and resources that are tailored to the unique medical needs of children,” says Henri Justino, MD, FSCAI, who is also chair of the Pediatric SCAI-QIT. “The toolkit was created by the cardiology community to help cardiologists optimize care for children with congenital heart disease.” The Pediatric SCAI-QIT includes four modules:
1. Catheterization Conferences: Addresses communication that should occur in catheterization laboratories.
2. Procedural Checklists: Reviews action items before, during, and after catheterization procedures.
3. Radiation Safety: Describes the rationale and strategies for reducing radiation exposure to patients and staff.
4. Procedural Quality: Discusses the rationale and overriding goals of quality improvement.
“The modules are flexible so that each institution can adopt practices based on their unique needs,” adds Dr. Justino. Each module provides a specific and detailed bibliography of resources on pediatric care as well as numerous internet links to give clinicians easy access to online resources. The modules also provide information on and access to registries as well as important benchmarking information.
The Pediatric SCAI-QIT will be continuously updated by physician authors to ensure that the latest quality standards are included. Additional modules are also expected as new data emerge. “Through this collaboration,” Dr. Justino says, “it’s hoped that we will stimulate thought and generate action from all team members within each catheterization laboratory so we can provide the highest quality of care. The toolkit enables clinicians to consistently evaluate and reevaluate interventional cardiology practices. It also reinforces improvement efforts in a timely manner while keeping up-to-date with treatment advances.”
Society for Cardiovascular Angiography and Interventions. Pediatric SCAI Quality Improvement Toolkit. Available at: http://www.scai.org/PEDQIT/Default.aspx.
Feltes TF, Bacha E, Beekman RH 3rd, et al; American Heart Association Congenital Cardiac Defects Committee of the Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; Council on Cardiovascular Radiology and Intervention; American Heart Association. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2607-2652.
Mehta R, Lee KJ, Chaturvedi R, Benson L. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv. 2008;72:278-285.
Bashore TM, Bates ER, Kern MJ, et al. American College of Cardiology/Society for Cardiac Angiography and Interventions clinical expert consensus document on cardiac catheterization laboratory standards: summary of a report of the American College of Cardiology Task Force on clinical expert consensus documents. Catheter Cardiovasc Interv. 2001;53:281-286.