PREDICTORS OF PROLONGED LENGTH OF INTENSIVE CARE UNIT STAY FOLLOWING STAGE I PALLIATION: A REPORT FROM THE NATIONAL PEDIATRIC CARDIOLOGY QUALITY IMPROVEMENT COLLABORATIVE

Our retrospective analysis of the Michigan Keystone intensive care unit (ICU) collaborative demonstrated that adult ICUs could achieve and sustain a zero rate of ventilator-associated pneumonia (VAP) for a considerable number of ventilator and calendar months. Moreover, the results highlight the importance of adjustment for ventilator-days before comparing VAP-free time among ICUs.

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Variability of antithrombotics use in patients with hypoplastic left heart syndrome and its variants following first- and second-stage palliation surgery: a national report using the National Pediatric Cardiology Quality Improvement Collaborative registry

Cardiology in the Young ◽

10.1017/s1047951116001189 ◽

2016 ◽

Vol 27 (4) ◽

pp. 731-738 ◽

Cited By ~ 1

Author(s):

Preeti Ramachandran ◽

Eileen King ◽

Ashley Nebbia ◽

Robert H. Beekman ◽

Jeffrey B. Anderson

Keyword(s):

Quality Improvement ◽

Adverse Events ◽

Pediatric Cardiology ◽

Stage I ◽

Stage Ii ◽

Left Heart ◽

Hypoplastic Left Heart ◽

Quality Improvement Collaborative ◽

Shunt Thrombosis ◽

Left Heart Syndrome

AbstractPurposePatients with hypoplastic left heart syndrome and its variants following palliation surgery are at risk for thrombosis. This study examines variability of antithrombotic practice, the incidence of interstage shunt thrombosis, and other adverse events following Stage I and Stage II palliation within the National Pediatric Cardiology Quality Improvement Collaborative registry.MethodsWe carried out a multicentre, retrospective review using the National Pediatric Cardiology Quality Improvement Collaborative registry including patients from 2008 to 2013 across 52 surgical sites. Antithrombotic medications used at Stage I and Stage II discharge were evaluated. Variability of antithrombotics use at the individual patient level and intersite variability, incidence of shunt thrombosis, and other adverse events such as cardiac arrest, seizure, stroke, and need for cardiac catheterisation intervention in the interstage period were identified. Antithrombotic strategies for hybrid Stage I patients were evaluated but they were excluded from the variability and outcomes analysis.ResultsA total of 932 Stage I and 923 Stage II patients were included in the study: 93.8% of Stage I patients were discharged on aspirin and 4% were discharged on no antithrombotics, and 77% of Stage II patients were discharged on aspirin and 17.5% were discharged on no antithrombotics. Only three patients (0.2%) presented with interstage shunt thrombosis. The majority of patients who died during interstage or required shunt dilation and/or stenting were discharged home on aspirin.ConclusionAspirin is the most commonly used antithrombotic following Stage I and Stage II palliation. There is more variability in the choice of antithrombotics following Stage II compared with Stage I. The incidence of interstage shunt thrombosis and associated adverse events was rare.

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Improved long-term survival in the patients with prolonged intensive care unit stay after cardiac surgery: influence of quality improvement program

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2016.03.035 ◽

2016 ◽

Vol 30 ◽

pp. S44

Author(s):

Alexander Kogan ◽

L. Sternik ◽

J. Lavee ◽

A. Lipey ◽

A. Shalabi ◽

...

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Quality Improvement ◽

Intensive Care Unit Stay ◽

Quality Improvement Program ◽

Improvement Program ◽

Term Survival ◽

Long Term Survival

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Using Economic Information in a Quality Improvement Collaborative

PEDIATRICS ◽

10.1542/peds.111.se1.e411 ◽

2003 ◽

Vol 111 (Supplement_E1) ◽

pp. e411-e418

Author(s):

Jeannette Rogowski

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Quality Improvement ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Care Quality ◽

Treatment Costs ◽

Quality Improvement Collaborative ◽

Intensive Care Unit Treatment ◽

Economic Information

This article provides an overview of neonatal intensive care unit treatment costs for hospitals that participated in the Neonatal Intensive Care Quality Improvement Collaborative Year 2000 (NIC/Q 2000) quality improvement collaborative and discusses how economic information can be used in quality improvement efforts. Detailed information on neonatal intensive care unit treatment costs is presented for 29 hospitals that participated in the NIC/Q 2000 collaborative. The sample consists of 6797 very low birth weight infants (1500 g or less at birth) with admission dates between January 1, 1997, and December 31, 1998. Information on median treatment cost per infant, ancillary costs, accommodation costs, length of stay, and cost per day is presented. In addition, ancillary costs are further disaggregated into those for respiratory therapy, laboratory, radiology, pharmacy, and all other ancillary services. The role of level of care and other factors that influence treatment costs are then explored.

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