New report: Pediatric heart surgery outcome data from 5 area hospitals

Today's guest blogger is Ryan R. Davies, MD, a cardiothoracic surgeon in the Division of Pediatric Cardiothoracic Surgery, Department of Surgery at Nemours/Alfred I. duPont Hospital for Children.

Last week, a first-of-its-kind report issued by the Pennsylvania Health Care Cost Containment Council published outcome data for regional children's hospitals that do pediatric heart surgery. This is important in that it represents a trend toward transparency in reporting and is directed toward and available to the health care consumer.

Nemours/Alfred I. duPont Hospital for Children in Delaware, The Children's Hospital of Philadelphia; Children's Hospital of Pittsburgh of UPMC; Geisinger Children's Hospital, Danville, Pa.; and Penn State Hershey Children's Hospital, Hershey, Pa, voluntarily participated in the report, providing its pediatric heart surgery statistics to the council. Hospitals reported survival rates at discharge for nine benchmark procedures designated by the Society for Thoracic Surgery (STS).

All five reporting hospitals achieved excellent outcomes with low mortality. Nationally, Nemours performed comparably or exceeded survival rates for the benchmark operations, which include repair of ventricular septal defect and Tetralogy of Fallot, the arterial switch operation and the Norwood procedure to correct hypoplastic left heart syndrome.

The STS standards are the best benchmarks we currently have and a very important first step. However, there are limitations. The data show survival at discharge, not long-term survival. As more children survive surgery and its immediate aftermath, the focus is shifting toward long-term survival and quality of life. For example, are kids who have had heart surgery as infants hitting their developmental milestones one or two years later? How can changes in surgical technique improve outcomes years later, not just at discharge? These are some of the questions we are asking in our research studies at Nemours.

J. William Gaynor, M.D., cardiothoracic surgeon at The Children's Hospital of Philadelphia commented on the new report in a press release from the Pennsylvania Health Care Cost Containment Council.

"The Children's Hospital of Philadelphia is proud to have contributed to this report which makes Pennsylvania a national leader when it comes to improving health outcomes for children needing pediatric heart surgery,"  he said.

"Every child deserves the highest quality care available and I applaud the Pennsylvania Health Care Cost Containment Council and the Society of Thoracic Surgeons for collaborating with hospitals and surgeons in Pennsylvania and Delaware on this effort. The project began when surgeons from each of the centers approached PHC4 with the concept of a collaboration of surgeons, hospitals, the Society of Thoracic Surgeons (STS) and PHC4 to begin public reporting of outcomes for congenital heart surgery," said Gaynor

Unfortunately, not all area hospitals that perform pediatric heart surgery participated in the survey. Providing this information is important to families and that is why many hospitals not only participate, but also make detailed outcomes information available on their websites. Cardiac surgery for adults and children continues to be at the forefront of surgical specialties in terms of both data collection and public reporting of outcomes. It is inevitable that the trend toward public data-sharing will ramp up considerably as consumers expect better information on which to base their health care decisions.

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