Impact of congenital cardiac catheterization project on outcomes-quality improvement (C3PO-QI) in LMICs
Document Type
Article
Department
Paediatrics and Child Health
Abstract
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 OutcomesQuality 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 reengineering 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.
Publication (Name of Journal)
Heart Asia
Recommended Citation
Ali, F.,
Mehdi, M. Q.,
Akhtar, S.,
Aslam, N.,
Abbas, R.,
Shah, I.,
Abidi, J.,
Arthur, S.,
Nizar, z.,
Hasan, B.
(2019). Impact of congenital cardiac catheterization project on outcomes-quality improvement (C3PO-QI) in LMICs. Heart Asia, 11(1).
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/812