BACKGROUND: The importance of registries for collaborative quality improvement has been overlooked in low/middle-income countries (LMIC). Aga Khan University Hospital (AKUH) in Pakistan joined the Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI) in March 2017 with the goal of leveraging international collaboration to improve patient care and institutional standards. METHODS: The C3PO-QI key driver-based approach was used, with certain modifications, for process re-engineering in AKUH's congenital cardiac catheterisation laboratory (CCL) to reduce radiation exposure during cardiac catheterisation procedures (the primary outcome of C3PO- QI). Educating staff and standardising procedural documentation were the principal goals of the process re-engineering. Data survey was used to assess staff knowledge, attitude and practice before and after the initiative. Additionally, case demographics and outcomes were compared between AKUH and C3PO-QI centres. RESULTS: There was an increase in appropriate recording of radiation surrogates (0%-100%, p=0.00) and in the percentage of cases that met the established benchmark of 'Ideal documentation' (35% vs 95%, p=0.001). There was also an increase in self-reported staff interest during the case (25% vs 75%, p=0.001). AKUH versus C3PO-QI data showed similar demographic characteristics. There was a slight over-representation of diagnostic cases (42% vs 32%) as compared with interventional (58% vs 68%) at AKUH. Furthermore, interventional procedures were predominately PDA and ASD device closures (n=19 and 15, respectively). The frequency of adverse events were the same between AKUH and collaborative sites. CONCLUSION: Collaborative efforts between developed and LMIC CCL are significant in advancing system-level processes.
BACKGROUND: The importance of registries for collaborative quality improvement has been overlooked in low/middle-income countries (LMIC). Aga Khan University Hospital (AKUH) in Pakistan joined the Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI) in March 2017 with the goal of leveraging international collaboration to improve patient care and institutional standards. METHODS: The C3PO-QI key driver-based approach was used, with certain modifications, for process re-engineering in AKUH's congenital cardiac catheterisation laboratory (CCL) to reduce radiation exposure during cardiac catheterisation procedures (the primary outcome of C3PO- QI). Educating staff and standardising procedural documentation were the principal goals of the process re-engineering. Data survey was used to assess staff knowledge, attitude and practice before and after the initiative. Additionally, case demographics and outcomes were compared between AKUH and C3PO-QI centres. RESULTS: There was an increase in appropriate recording of radiation surrogates (0%-100%, p=0.00) and in the percentage of cases that met the established benchmark of 'Ideal documentation' (35% vs 95%, p=0.001). There was also an increase in self-reported staff interest during the case (25% vs 75%, p=0.001). AKUH versus C3PO-QI data showed similar demographic characteristics. There was a slight over-representation of diagnostic cases (42% vs 32%) as compared with interventional (58% vs 68%) at AKUH. Furthermore, interventional procedures were predominately PDA and ASD device closures (n=19 and 15, respectively). The frequency of adverse events were the same between AKUH and collaborative sites. CONCLUSION: Collaborative efforts between developed and LMIC CCL are significant in advancing system-level processes.
Authors: Lisa Bergersen; Kimberlee Gauvreau; Susan R Foerster; Audrey C Marshall; Doff B McElhinney; Robert H Beekman; Russel Hirsch; Jacqueline Kreutzer; David Balzer; Julie Vincent; William E Hellenbrand; Ralf Holzer; John P Cheatham; John W Moore; Grant Burch; Laurie Armsby; James E Lock; Kathy J Jenkins Journal: JACC Cardiovasc Interv Date: 2011-09 Impact factor: 11.195
Authors: John Deanfield; Erik Thaulow; Carol Warnes; Gary Webb; Frantizek Kolbel; Andreas Hoffman; Keld Sorenson; Harald Kaemmer; Ulf Thilen; Margaret Bink-Boelkens; Laurence Iserin; Luciano Daliento; Eric Silove; Andrew Redington; Pascal Vouhe; Silvia Priori; Maria Angeles Alonso; Jean-Jacques Blanc; Andrzej Budaj; Martin Cowie; Jaap Deckers; Enrique Fernandez Burgos; John Lekakis; Bertil Lindahl; Gianfranco Mazzotta; Joao Morais; Ali Oto; Otto Smiseth; Hans Joachim Trappe; Werner Klein; Carina Blömstrom-Lundqvist; Guy de Backer; Jaromir Hradec; Gianfranco Mazzotta; Alexander Parkhomenko; Patrizia Presbitero; Adam Torbicki Journal: Eur Heart J Date: 2003-06 Impact factor: 29.983
Authors: George R Verghese; Doff B McElhinney; Keith J Strauss; Lisa Bergersen Journal: Catheter Cardiovasc Interv Date: 2011-12-08 Impact factor: 2.692
Authors: Kathy J Jenkins; Robert H Beekman Iii; Lisa J Bergersen; Allen D Everett; Thomas J Forbes; Rodney C G Franklin; Thomas S Klitzner; Otto N Krogman; Gerard R Martin; Catherine L Webb Journal: Cardiol Young Date: 2008-12 Impact factor: 1.093
Authors: Brian P Quinn; Mary Yeh; Kimberlee Gauvreau; Fatima Ali; David Balzer; Oliver Barry; Sarosh Batlivala; Darren Berman; Susan Foerster; Bryan Goldstein; Michael Hainstock; Ralf Holzer; Dana Janssen; Michael L O'Byrne; Lauren Shirley; Sara Trucco; Wendy Whiteside; Lisa Bergersen Journal: J Am Heart Assoc Date: 2021-12-22 Impact factor: 6.106