RT Journal Article
SR Electronic
T1 Impact of International Quality Improvement Collaborative on Congenital Heart Surgery in Pakistan
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2016-310533
DO 10.1136/heartjnl-2016-310533
A1 Amina Khan
A1 Ahmed Abdullah
A1 Huzaifa Ahmad
A1 Arjumand Rizvi
A1 Sehrish Batool
A1 Kathy J Jenkins
A1 Kimberlee Gauvreau
A1 Muneer Amanullah
A1 Anwar Haq
A1 Nadeem Aslam
A1 Fauzia Minai
A1 Babar Hasan
YR 2017
UL http://heart.bmj.com/content/early/2017/04/13/heartjnl-2016-310533.abstract
AB Background The International Quality Improvement Collaborative (IQIC) was formed to reduce mortality and morbidity from congenital heart disease (CHD) surgeries in low/middle-income countries.Objectives We conducted this study to compare the postoperative outcomes of CHD surgeries at a centre in Pakistan before and after joining IQIC.Methods The IQIC provides guidelines targeting key drivers responsible for morbidity and mortality in postoperativepatients with CHD. We focused primarily on nurse empowerment and improving the infection control strategies at our centre. Patients with CHD who underwent surgery at this site during the period 2011–2012 (pre-IQIC) were comparedwith those getting surgery in 2013–2014 (post-IQIC). Morbidity (major infections), mortality and factors associated with them were assessed.Results There was a significant decrease in surgical site infections and bacterial sepsis in the post-IQIC versus pre-IQIC period (1% vs 30%, p=0.0001, respectively). A statistically insignificant decrease in the mortality rate was also noted in post-IQIC versus pre-IQIC period (6% vs 9%, p=0.17, respectively). Durations of ventilation and intensive care unit (ICU) and hospital stay were significantly reduced in the post-IQIC period. Age <1 year, malnutrition, low preoperative oxygen perfusion, Risk Adjustment for Congenital Heart Surgery score >3, major chromosomal anomalies, perfusion-related event, longer ventilation and ICU/hospital stay durations were associated with greater odds of morbidity and mortality.Conclusion Enrolling in the IQIC programme was associated with an improvement in the postsurgical outcomes of the CHD surgeries at our centre.