Databases for assessing the outcomes of the treatment of patients with congenital and pediatric cardiac disease: The perspective of critical care

Abstract

Several barriers exist that make measuring critical care outcomes and quality a challenge. Particularly in the field of pediatric cardiac critical care it can be difficult to disentangle an intensive care unit’s contribution to patient outcome from those of other services (e.g. surgery), and appropriate risk-adjustment remains an elusive goal. Databases provide a key source of information that can be used to overcome some of these barriers. We explain the key database components necessary to provide clinicians and researchers with the foundation to measure and improve quality in this clinical arena. Databases that are currently used in the critical care community are described, including the Virtual PICU System (VPS) database. The chapter concludes with a discussion of how to move from simply assessing patient outcomes using databases to achieving quality improvement through collaborative. We review new collaborative in pediatric cardiac critical care and cardiac surgery, the Pediatric Cardiac Critical Care Consortium (PC4), that is implementing the lessons learned from successful quality improvement pioneers.