Cardiovascular Program

When you are making a decision about where to bring your child for care, you want all the information you can get. You want to know how good a hospital is at treating the specific condition your child is facing. You also want to know how a hospital ranks in terms of keeping your child safe and healthy during his or her stay. These measurements are referred to as “outcomes.”

This page lays out information to help you compare Children’s Hospitals and Clinics of Minnesota with similar hospitals locally and across the country. The categories here represent “quality measures” outlined by the Institute of Medicine. These categories are seen as a good way to compare facilities. - See all hospital outcomes here.

Achieving the best possible outcomes


Cardiovascular Surgical Services - Actual to Predicted Mortality Ratio

Cardiovascular Surgical Services
Actual to Predicted Mortality Ratio 2007-2012

outcomes star

Our hospital

.50

2007-2012

 outcomes table line

41 other
children's
hospitals

.58

2007-2012

Evaluating this chart: Lower is better.

We never want to see a child die, but sometimes, their illness is simply too advanced to treat. We track how we are doing at saving lives through the "Mortality Ratio." This compares how many patients died at Children's, to how many we expected would die given how sick they were when they came to Children's. The good news is that fewer patients died at our hospital than we expected based on their illness. We do our best to deliver miracles.

How we are improving: We review every death to see if we could given more effective care to the child. We examine our past experience and improve our care with every child we treat.


Cardiovascular Medical Services - Actual to Predicted Mortality Ratio

Cardiovascular Medical Services
Actual to Predicted Mortality Ratio 2007-2012

outcomes star

Our hospital

.90

2007-2012

 outcomes table line

41 other
children's
hospitals

1.00

2007-2012

Evaluating this chart: Lower is better.

We never want to see a child die, but sometimes, their illness is simply too advanced to treat. We track how we are doing at saving lives through the "Mortality Ratio." This compares how many patients died at Children's, to how many we expected would die given how sick they were when they came to Children's. The good news is that fewer patients died at our hospital than we expected based on their illness. We do our best to deliver miracles.

How we are improving: We review every death to see if we could given more effective care to the child. We examine our past experience and improve our care with every child we treat.


Cardiovascular Surgery Hospital Mortality 2008-2011

Cardiovascular Surgery Hospital Mortality %
2008-2011

outcomes star

Our hospital

2.2

2008-2011
 outcomes table line

Other
children's
hospitals

3.5

2008-2011

Evaluating this chart: Lower is better.

We never want to see a child die, but sometimes, their illness is simply too advanced to treat. We track how we are doing at saving lives through the "Mortality Percentage." This compares us to all pediatric hospitals in the United States that participate in this surgical database. The good news is that fewer patients died at our hospital compared to other hospitals in this surgical database. We do our best to deliver miracles.

How we are improving: We review every death to see if we could given more effective care to the child. We examine our past experience and improve our care with every child we treat.


Hospital Mortality for High-Risk Patients at High Volume Surgical Centers 2008-2011

Hospital Mortality (%)

outcomes star

Our hospital

3%

2008-2011
 outcomes table line

42 other
children's
hospitals
national average

17%

2008-2011

Evaluating this chart: Lower is better.

We never want to see a child die, but sometimes, their illness is simply too advanced to treat. We track how we are doing at saving lives through the "Mortality Percentage." This compares us to all pediatric hospitals that perform more than 300 heart surgeries every year in the United States. The good news is that fewer patients died at our hospital compared to other hospitals in this surgical database. We do our best to deliver miracles.

How we are improving: We review every death to see if we could given more effective care to the child. We examine our past experience and improve our care with every child we treat.

Using resources wisely


Cardiovascular Surgical Services
Actual to Predicted Length of Stay Ratio

outcomes star

Our
hospital

0.8

2007-2012

 outcomes table line

42 other
children's
hospitals average

1.0

2007-2012

Evaluating this chart: Lower is better. Average: 1.0

Actual-to-Predicted Length of Stay - Surgical Services

The length-of-stay ratio compares how long a patient stays in the hospital (actual), to how long we thought they would stay given how sick they were when they came to Children's. A ratio of < 1.0 means a patient's stay was shorter than we expected, which means most children can go home sooner than we thought! Children's performs better than other pediatric hospitals on this outcome.

How we are improving: We start planning for your child to go home as soon as possible as s/he is admitted. That includes teaching you how to care for your child at home, give medications, and arrange for home care if needed.


Cardiovascular Medical Services
Actual to Predicted Length of Stay Ratio

outcomes star

Our
hospital

0.8

2007-2012

 outcomes table line

42 other
children's
hospitals average

1.1

2007-2012

Evaluating this chart: Lower is better. Average: 1.1

Actual-to-Predicted Length of Stay - Medical Services

The length-of-stay ratio compares how long a patient stays in the hospital (actual), to how long we thought they would stay given how sick they were when they came to Children's. A ratio of < 1.0 means a patient's stay was shorter than we expected, which means most children can go home sooner than we thought! Children's performs better than other pediatric hospitals on this outcome.

How we are improving: We start planning for your child to go home as soon as possible as s/he is admitted. That includes teaching you how to care for your child at home, give medications, and arrange for home care if needed.

Patient/Family Satisfaction


Told about progress of child's surgery

Told about progress of child's surgery
(Positive score)

outcomes star

Our hospital

86

2011

91

2012

 outcomes table line

Evaluating this chart: Higher is better. 

This data comes from feedback provided in our patient satisfaction surveys. The score represents the percentage of families that reply and are very satisfied with their child's care.


Knew which doctor was in charge of care

Knew which doctor was in charge of care
(Positive score)

outcomes star

Our hospital

86

2011

96

2012

 outcomes table line

Evaluating this chart: Higher is better.

This data comes from feedback provided in our patient satisfaction surveys. The score represents the percentage of families that reply and are very satisfied with their child's care.


Rate of availability of child's nurses

Rate of availability of child's nurses
(Positive score)

outcomes star

Our hospital

86

2011

81

2012

 outcomes table line

Evaluating this chart: Higher is better.

This data comes from feedback provided in our patient satisfaction surveys. The score represents the percentage of families that reply and are very satisfied with their child's care.


Overall satisfaction with child's care

Overall satisfaction with child's care
(Positive score)

 outcomes star

Our Hospital

99

2011

96

2012

Evaluating this chart: Higher is better.

This data comes from feedback provided in our patient satisfaction surveys. The score represents the percentage of families that reply and are very satisfied with their child's care.
 

Infection prevention


Central Line Associated Bloodstream Infections

Central Line Associated Bloodstream Infections–CVCC

 outcomes star

Our Hospital

0

Jan-Mar
2012

1.7

Apr-Jun
2012

0

Jul-Sep
2012

2

Oct-Dec
2012

Evaluating this chart: Lower is better. Goal: 0

In hospitals, we use "intravenous lines" (IVs) to help give medications to sick patients. One type of IV is a "central line", which is a thin tube inserted into a large vein that goes ot the heart. Central lines can be very useful for taking care of some children. However, because the IV goes directly to the bloodstream, bacteria (germs) can also enter the bloodstream and cause infection if we don't follow standard procedures when using the line to give medicine. These infections are called "Central Line-Associated Bloodstream Infections" (CLABSIs).  

How we are improving: Nurses and doctors follow a standard "bundle" of methods when inserting the central line, and when caring for the line after it is inserted to make sure it is kept clean. They also wash their hands before they use an IV to give a medicine. Children's also participates in two national projects with other children's hospitals to share best practices to prevent these infections. Our ultimate goal is to have zero CLABSIs. 

These six areas for measuring quality of care were developed by the Institute of Medicine and are widely used by health care organizations. If you have a question about Children's data, we encourage you to speak to your physician. We are happy to talk to you about program outcomes and the prognosis for your child.

Safe 

Interpretation: Children's average Central Line Associated Bloodstream Infections (CLABSI) rate was higher than the national average reported for other pediatric cardiovascular units recently. A focused response is being conducted in this unit to address the increase and drive improvement. Our ultimate goal is to have zero CLABSIs.

What are we doing to improve: Children's has implemented central line "bundles" which are a set of best practices used to prevent infections when inserting and maintaining lines. We monitor adherence to the bundles and provide ongoing education to staff.

Data source: Children's Infection Prevention and Control Surveillance Data

Benchmark data: "National Healthcare Safety Network (NHSN) Report, Data Summary for 2009, Device-associated Module". Published by the Association for Professionals in Infection Control and Epidemiology, Inc. (Am J Infect Control 2009;37:783-805)

Timing 

This measure still in process.

Efficient 

Interpretation: The length-of-stay ratio compares how long a patient stays in the hospital (actual) to how long they are predicted to stay given the severity of their illness. A ratio of < 1.0 means a patient’s stay was less than expected. Children's performs better than its peers.

What we are doing to improve: Improved discharge planning is the focus of an ongoing quality improvement project.

Data source: Pediatric Health Information System database sponsored by Child Health Corporation of America.

Benchmark data: Average of 43 other children's hospitals. The other children's hospitals ratio can be greater than 1.0 because the expected length of stay comes from a larger, national database. 

Effective

Interpretation: Hospital mortality is the percentage of patients who died during their hospitalization for heart surgery (excluding PDA ligations on patients weighing less than 2500 grams). This rate is not adjusted for severity of illness. Children’s mortality rate compares favorably to the national average.

What are we doing to improve: We conduct a monthly review of surgical cases to discuss ways to improve patient outcomes. Children’s opened a new Cardiovascular Care Center in April 2010. This consolidates all care for heart patients to one floor. We have implemented a new model of care staffing the unit 24/7 with in-house cardiac intensive care physicians. Standardized treatment protocols have also been developed to improve patient care.

Data source: Society of Thoracic Surgeons Congenital Heart Surgery Database - http://www.sts.org/, Table 5 from Spring Harvest 2011.

Benchmark data: 96 hospitals (85 in US, 1 in Canada).

Interpretation: Hospital mortality is the percentage of patients who died during their hospitalization for heart surgery (excluding PDA ligations on patients weighing less than 2500 grams). High-volume hospitals do more than 250 cardiac surgeries per year and have a more reliable estimate of performance than low volume centers where numbers are subject to random variation. These are the most complex and highest risk patients.

Children’s has one of the best survival to discharge rates for high-risk* heart surgeries when compared to high-volume hospitals. Our hospital had 1 deaths out of 59 patients.

*These surgeries are classified by RACHS-1 (Risk Adjustment for Congenital Heart Surgery). RACHS-1 has levels 1-6 in order of increasing complexity and risk. High-risk surgeries include RACHS-1 levels 5-6: Norwood procedure or Damus-Kaye-Stansel procedure for single ventricle palliation, and repair of Ebstein’s anomaly in patients less than 30 days old.

What are we doing to improve: We conduct a monthly review of surgical cases to discuss ways to improve patient outcomes. Children’s has developed a home monitoring program for patients with hypoplastic left heart syndrome, which has been shown to improve survival to their next operation. Children’s Neurodevelopmental Clinic has also developed a follow-up program for patients with congenital heart disease to evaluate and improve long-term outcomes.

Data source: Society of Thoracic Surgeons Congenital Heart Surgery Database - http://www.sts.org/, Table 7 from Spring Harvest 2011.

Benchmark data: 42 hospitals.

Patient-family centered 

Willing to recommend 

 

Interpretation: Most families would definitely recommend Children's to a friend or family member for care. Seven percent of families said they would not recommend Children's in the latest time period. We are currently above our goal of 90%.

What are we doing to improve: We use feedback from our Family Advisory Council and family surveys to improve family experiences.

Data source: NRC Picker Family Survey

BENCHMARK DATA: Not available.

Care and compassion 

Interpretation: Most families said staff definitely showed care and compassion. Twenty percent of families said staff somewhat showed care and compassion, and no families said staff did not show care and compassion in the latest time period. We are currently below our goal of 90%.

What are we doing to improve: All patient care areas are working on ways to continuously improve expressions of care and compassion, including implementation of family centered rounds, family liaisons for all units, and interpreter services on daily rounds.

Data source: NRC Picker Family Survey

Benchmark data: Not available.

Equitable 

This measure is still in process.

Delivering next-generation care requires a multidisciplinary team. Children’s pediatric cardiovascular team has extensive experience and specialized training in the unique heart problems of infants, children, adolescents, and long-term adult patients with pediatric heart conditions. The Children’s team includes 11 board-certified pediatric cardiologists, two pediatric cardiovascular surgeons, and highly-skilled pediatric cardiac nurses who are certified in the appropriate advanced competencies and skills. Other team members include caregivers from specialized services such as pediatric critical care, neonatology, extra corporeal membrane oxygenation (ECMO), pediatric anesthesia, pediatric nursing, laboratory, respiratory therapy, social work, child life, and care management.

During your visit, you may meet some of the following team members:

Cardiovascular program leaders 

Pediatric cardiologists

Pediatric cardiovascular surgeons

ECMO consulting physicians

Other providers

Other teams involved with the cardiovascular program