Early on the morning of June 18, Texas Children’s Heart Center staff filed into Taussig auditorium on the 16th floor of Lester and Sue Smith Legacy Tower. Details about the meeting’s purpose had been scarce. Little did everyone know that they’d been called in for a big reveal.
Texas Children’s Heart Center had once again been named the best place in the country for pediatric cardiology and heart surgery in the U.S. News and World Report 2019-2020 Best Children’s Hospitals rankings – the center’s third straight year at No. 1.
“It’s thrilling for our team to be recognized for the care we provide to our patients every day,” said Chief of Pediatric Cardiology Dr. Daniel Penny. “Even though we received the top honor, we know there is always room for improvement. We are continuing to evolve as a true multidisciplinary team that is dedicated to setting a new standard for the treatment of children and adults with congenital heart disease.”
The U.S. News rankings use a well-accepted framework for evaluating quality of health care, which factors in patient outcomes, such as mortality and infection rates; available clinical resources, such as specialized clinics and programs and external accreditations; and compliance with best practices. Improved rankings demonstrate a health care organization’s commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.
But where do you go when you’re No. 1?
“Our goal is to be so far ahead that no one can catch us,” said Dr. Christopher Caldarone, Texas Children’s chief of Congenital Heart Surgery. “Being No. 1 is a state of mind, where commitment to excellence is inherent in everything a program does. Our team has a No. 1 mindset. We work hard, we constantly measure our performance, and we drive ourselves to improve in every aspect of providing care.”
Big wins for patients and families
This past year, the Heart Center built on the successes of previously existing programs and also implemented new initiatives to increase transparency, reduce risk of infection and improve the quality of care.
- Participated in STS National Database public reporting
The Society of Thoracic Surgeons (STS) is a national leader in health care transparency and accountability. Participation in STS public reporting demonstrates a commitment to quality improvement in health care delivery and helps provide patients and families with access to information that can help them make more informed health care decisions.
Texas Children’s holds a three-star rating in the STS Congenital Heart Surgery Database (CHSD), which is calculated based on overall risk-adjusted operative mortality for all patients undergoing pediatric and/or congenital heart surgery. The rating is the highest category of quality and places Texas Children’s among the elite congenital heart surgery programs in the U.S. and Canada. Additionally, STS recognized Texas Children’s for having operative and adjusted operative mortality rates that were consistently below expected rates over a 4-year period.
- Implemented a program to routinely track and submit IMPACT data
In partnership with clinical and physician leadership, the Heart Center’s Cardiac Catheterization Labs implemented processes to submit metrics on all catheterization procedures included in the American College of Cardiology’s IMPACT Registry®. This national register collects quality-focused data on the management and outcomes of pediatric and adult congenital heart disease (ACHD) patients who undergo diagnostic and interventional cardiac catheterization procedures. The registry also allows Heart Center leadership to compare performance against a national aggregate for quality improvement initiatives.
- Increased the number of cardiac intensive care unit (CICU) RNs with greater than 2 years’ experience
CICU care requires a multidisciplinary team effort. Success is due, in part, to the team’s being able to rely on experience. In the months leading up to the Heart Center’s move into Lester and Sue Smith Legacy Tower, CICU leadership worked tirelessly to not only recruit the very best nurses, but also to retain them. This enables the nurses to gain valuable experience and mature as caregivers, and also helps improve the overall quality of the CICU team. The response has been extremely positive, with low turnover.
- Implemented a universal methicillin-resistant Staphylococcus aureus (MRSA) decolonization treatment protocol
To reduce the risk of infection faced by all surgical patients during the perioperative period, the Congenital Heart Surgery team partnered with experts from Infectious Disease to implement a universal decolonization protocol for MRSA, which causes infections that are more difficult to treat than methicillin-susceptible staph. The protocol, which involves five days of antibiotic ointment in the nose and five days of special wipes, has the added benefit of decreasing MRSA wound infections, and incidence of methicillin-susceptible staph ventilated-associated pneumonia and central line infections.