CV Performance Page

MCH Cardiac Real-time Performance Assessment Tool

Our program goal is to improve continuously.
To achieve this, we measure our performance continuously, and report in real time.
We believe this practice will enhance our ability to identify and correct clinical problems, and provide our colleagues and patients with accurate and useful outcomes data for decision making. Recognizing the inherent weaknesses of conventional databases, and the frustrating problem of identifying missing or erroneous data, we encourage our families, referring doctors, and team members, to alert the database administrator to potential inaccuracies, so that they can be confirmed and corrected. Having our Web based reporting system linked to our patient’s electronic medical records gives us access to phenomenal amounts of data, and this Website only gives a snapshot of the available information. We therefore encourage our users to suggest the types of data they would find useful, and would like to see presented in real time. Ongoing feedback, from everyone involved in the care of our patients, would make this database a uniquely powerful tool, and a model for medical performance measurement.

The data you see below is generated dynamically by our cardiac program database, in real time, every time you load this page.
Operative mortality is defined, by International convention, as death before discharge from the hospital or within 30 days of the operation.

Performance Sparkline

Each tick mark in the graphic below represents a cardiac surgical procedure. Surviving patients are indicated by upward tick marks
and mortalities are indicated by the downward tick marks in the sequence. Every 250 cases the graphic wraps to the next line for
comparison. The sparkline is read like a book from left to right and from top to bottom.

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Performance Analysis by Age

All fields below are dynamic - updated in real-time from the cardiac program electronic medical record.

Last Procedure Recorded on 3/8/2010

Category	Procedures (N)	Open Heart (N)	Closed Heart (N)	Open Heart Mortality (N)	Open Heart Mortality (%)
Neonates	610	489	121	32	5.25
Adult	99	80	19	1	1.01
Children	823	742	81	7	0.85
Infant	824	733	91	7	0.85
Totals	2356	2044	312	47	2.3

{Adult > 18 Yrs, Children 1 - 18 Yrs, Infant 31 Days to 1 Yr, Neonates 0 - 30 Days}

Performance Analysis by Procedure and Complexity

All fields below are dynamic - updated in real-time from the cardiac program electronic medical record.

Last Procedure Recorded on 3/8/2010

Generate a real-time Kaplan-Meier Survival Curve for this program by clicking on the corresponding blue procedure name below.

Procedure	Patients (N)	Median LOS (Days)	Median Age (Days)	Mortalities	Percent Mortality	Rachs
ASD	107	3	1162	0	0	1
PAPVR	62	3	2671	0	0	1
AP Win	2	4	6	0	0	2
BDCPA	139	7	173	0	0	2
Sub AS	29	3	2093	0	0	2
TOF	150	6	107	2	1.33	2
VSD	208	5	170	0	0	2
ALCAPA	6	15	119	0	0	3
ASO	81	15	6	0	0	3
AVC	85	7	140	0	0	3
DORV	33	10	107	0	0	3
Fontan	135	10	1592	2	1.48	3
PA/VSD	16	21	9	0	0	3
ASO/VSD	8	14	8	0	0	4
IAA	15	20	8	0	0	4
Konno	14	7	2545	1	7.14	4
Rastelli	11	7	324	0	0	4
Truncus	22	23	14	0	0	4
DKS	21	23	10	1	4.76	6
Norwood Stage 1	84	23	7	8	9.52	6
Totals	1228	11.3	563.55	14	1.14	2.61

Performance Comparison by Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) Score

All fields below are dynamic - updated in real-time from the cardiac program electronic medical record, except
light blue fields which contain fixed values from the medical literature. References provided below.

RACHS-1 (1)	Patients (N)	Median LOS (Days)	Median Age (Days)	Mortalities	MCH % Mortality	PCCC (2) % Mortality	EJCTS (3) % Mortality
1	169	3	1659	0	0	0.4	0.3
2	526	6	159	2	0.38	3.8	4
3	356	12	176	2	0.56	8.5	5.6
4	70	17	19	1	1.43	19.4	9.9
5	0	0	0	0	0	0	50
6	104	23	7	9	8.65	47.7	40.1

References:
1. Jenkins KJ.,Risk adjustment for congenital heart surgery: the RACHS-1 method,Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2004;7:180-4.
2. Jenkins KJ, Gauvreau K., Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenital Heart Surgery (RACHS-1) method,
Thorac Cardiovasc Surg. 2002 Jul;124(1):97-104.
3. Boethig D, Jenkins KJ, Hecker H, Thies WR, Breymann T.,
The RACHS-1 risk categories reflect mortality and length of hospital stay in a large German pediatric cardiac surgery population,
Eur J Cardiothorac Surg. 2004 Jul;26(1):12-7.