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 7/2/2009

Category	Procedures (N)	Open Heart (N)	Closed Heart (N)	Open Heart Mortality (N)	Open Heart Mortality (%)
Adult	82	64	18	1	1.22
Children	775	696	79	7	0.9
Infant	755	668	87	7	0.93
Neonates	564	451	113	31	5.5
Totals	2176	1879	297	46	2.45

{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 7/1/2009

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	97	3	1092	0	0	1
PAPVR	60	3	2500	0	0	1
AP Win	2	4	6	0	0	2
BDCPA	133	7	176	0	0	2
Sub AS	26	3	2093	0	0	2
TOF	141	7	105	2	1.42	2
VSD	196	5	170	0	0	2
ALCAPA	5	10	119	0	0	3
ASO	76	16	7	0	0	3
AVC	77	8	134	0	0	3
DORV	31	10	99	0	0	3
Fontan	127	9	1627	2	1.57	3
PA/VSD	16	21	9	0	0	3
ASO/VSD	4	15	8	0	0	4
IAA	13	20	8	0	0	4
Konno	14	7	2545	1	7.14	4
Rastelli	11	7	324	0	0	4
Truncus	20	23	15	0	0	4
DKS	20	26	13	1	5	6
Norwood Stage 1	80	23	7	8	10	6
Totals	1149	11.35	552.85	14	1.22	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	157	3	1672	0	0	0.4	0.3
2	496	6	160	2	0.4	3.8	4
3	332	12	172	2	0.6	8.5	5.6
4	62	18	24	1	1.61	19.4	9.9
5	0	0	0	0	0	0	50
6	99	24	7	9	9.09	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.