Improvement in Interstage Survival in a National Pediatric Cardiology Learning Network

Name: Work Video:
Duration: 3 min 30 s
Jeffrey Anderson; Robert H. Beekman; John D. Kugler; Geoffrey L. Rosenthal; Kathy J. Jenkins; Thomas S. Klitzner; Gerard R. Martin; Steven R. Neish; David W. Brown; Colleen Mangeot; Eileen King; Laura E. Peterson; Lloyd Provost; Carole Lannon
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1336, 1354, 1361, 1378, 1387, 1417, 1448, 1464, 1471, 1488, 1497, 1527, 1558, 1574, 1581, 1598, 1607, 1637, 1668, 2224], 'Medical': [127, 135, 151, 169, 190, 221, 239, 247, 263, 281, 302, 333, 351, 359, 375, 393, 414, 445, 463, 471, 487, 505, 526, 557, 575, 583, 599, 617, 638, 669, 687, 695, 711, 729, 750, 781, 799, 807, 823, 841, 862, 893, 911, 919, 935, 953, 974, 1005, 1023, 1031, 1047, 1065, 1086, 1117, 1133, 1141, 1157, 1175, 1196, 1227, 1243, 1251, 1267, 1285, 1306, 1337, 1355, 1363, 1379, 1397, 1418, 1449, 1465, 1473, 1489, 1507, 1528, 1559, 1575, 1583, 1599, 1617, 1638, 1669, 2225], 'Center,': [128, 136, 152, 170, 178, 191, 222, 240, 248, 264, 282, 290, 303, 334, 352, 360, 376, 394, 402, 415, 446, 464, 472, 488, 506, 514, 527, 558, 576, 584, 600, 618, 626, 639, 670, 688, 696, 712, 730, 738, 751, 782, 800, 808, 824, 842, 850, 863, 894, 912, 920, 936, 954, 962, 975, 1006, 1024, 1032, 1048, 1066, 1074, 1087, 1118, 1134, 1142, 1158, 1176, 1184, 1197, 1228, 1244, 1252, 1268, 1286, 1294, 1307, 1338, 1356, 1364, 1380, 1398, 1406, 1419, 1450, 1466, 1474, 1490, 1508, 1516, 1529, 1560, 1576, 1584, 1600, 1618, 1626, 1639, 1670], 'OH': [129, 193, 224, 241, 305, 336, 353, 417, 448, 465, 529, 560, 577, 641, 672, 689, 753, 784, 801, 865, 896, 913, 977, 1008, 1025, 1089, 1120, 1135, 1199, 1230, 1245, 1309, 1340, 1357, 1421, 1452, 1467, 1531, 1562, 1577, 1641, 1672], '(J.B.A.,': [130, 242, 354, 466, 578, 690, 802, 914, 1026, 1136, 1246, 1358, 1468, 1578], 'R.H.B.);': [131, 243, 355, 467, 579, 691, 803, 915, 1027, 1137, 1247, 1359, 1469, 1579], '&': [134, 246, 358, 470, 582, 694, 806, 918, 1030, 1140, 1250, 1362, 1472, 1582], 'Omaha,': [137, 249, 361, 473, 585, 697, 809, 921, 1033, 1143, 1253, 1365, 1475, 1585], 'NE': [138, 250, 362, 474, 586, 698, 810, 922, 1034, 1144, 1254, 1366, 1476, 1586], '(J.D.K.);': [139, 251, 363, 475, 587, 699, 811, 923, 1035, 1145, 1255, 1367, 1477, 1587], 'University': [140, 161, 174, 252, 273, 286, 364, 385, 398, 476, 497, 510, 588, 609, 622, 700, 721, 734, 812, 833, 846, 924, 945, 958, 1036, 1057, 1070, 1146, 1167, 1180, 1256, 1277, 1290, 1368, 1389, 1402, 1478, 1499, 1512, 1588, 1609, 1622], 'of': [141, 144, 162, 175, 183, 253, 256, 274, 287, 295, 365, 368, 386, 399, 407, 477, 480, 498, 511, 519, 589, 592, 610, 623, 631, 701, 704, 722, 735, 743, 813, 816, 834, 847, 855, 925, 928, 946, 959, 967, 1037, 1040, 1058, 1071, 1079, 1147, 1150, 1168, 1181, 1189, 1257, 1260, 1278, 1291, 1299, 1369, 1372, 1390, 1403, 1411, 1479, 1482, 1500, 1513, 1521, 1589, 1592, 1610, 1623, 1631, 1693, 1702, 1716, 1790, 1845, 1896, 2010, 2026, 2084, 2170, 2175, 2186, 2192, 2235, 2248, 2375, 2421, 2442, 2466, 2477, 2516, 2525, 2534, 2547, 2562, 2570, 2585, 2619, 2628, 2655, 2663, 2670, 2677, 2683, 2691, 2708, 2725, 2732, 2740, 2746, 2754, 2765, 2771, 2778, 2788, 2794, 2805, 2822, 2828, 2837, 2851, 2856, 2864, 2873, 2889, 2906, 2915, 2926, 2934, 2944, 2955, 2963, 2971, 2992, 3000, 3008, 3018, 3026, 3038, 3046, 3052, 3163, 3204, 3209, 3212, 3329, 3332, 3345, 3362, 3368, 3460, 3555, 3569, 3605, 3620, 3625, 3632, 3637, 3721, 3734, 3740, 3759, 3767, 3780, 3812, 3832, 3835, 3867, 3882, 3898, 3904, 3976, 4013, 4024], 'Maryland': [142, 254, 366, 478, 590, 702, 814, 926, 1038, 1148, 1258, 1370, 1480, 1590], 'School': [143, 255, 367, 479, 591, 703, 815, 927, 1039, 1149, 1259, 1371, 1481, 1591], 'Medicine,': [145, 257, 369, 481, 593, 705, 817, 929, 1041, 1151, 1261, 1373, 1483, 1593], 'Baltimore': [146, 258, 370, 482, 594, 706, 818, 930, 1042, 1152, 1262, 1374, 1484, 1594], '(G.L.R.);': [147, 259, 371, 483, 595, 707, 819, 931, 1043, 1153, 1263, 1375, 1485, 1595], 'Boston': [148, 260, 372, 484, 596, 708, 820, 932, 1044, 1154, 1264, 1376, 1486, 1596], 'Boston,': [153, 199, 265, 311, 377, 423, 489, 535, 601, 647, 713, 759, 825, 871, 937, 983, 1049, 1095, 1159, 1205, 1269, 1315, 1381, 1427, 1491, 1537, 1601, 1647], 'MA': [154, 200, 266, 312, 378, 424, 490, 536, 602, 648, 714, 760, 826, 872, 938, 984, 1050, 1096, 1160, 1206, 1270, 1316, 1382, 1428, 1492, 1538, 1602, 1648], '(K.J.J.,': [155, 267, 379, 491, 603, 715, 827, 939, 1051, 1161, 1271, 1383, 1493, 1603], 'D.W.B.);': [156, 268, 380, 492, 604, 716, 828, 940, 1052, 1162, 1272, 1384, 1494, 1604], 'Mattel': [157, 269, 381, 493, 605, 717, 829, 941, 1053, 1163, 1273, 1385, 1495, 1605], 'at': [160, 272, 384, 496, 608, 720, 832, 944, 1056, 1166, 1276, 1388, 1498, 1608, 1838, 2081, 2221, 2574, 2697, 3160, 3172, 3250, 3407, 3519, 3885, 3921, 3966, 4003], 'California,': [163, 275, 387, 499, 611, 723, 835, 947, 1059, 1169, 1279, 1391, 1501, 1611], 'Los': [164, 276, 388, 500, 612, 724, 836, 948, 1060, 1170, 1280, 1392, 1502, 1612], 'Angeles': [165, 277, 389, 501, 613, 725, 837, 949, 1061, 1171, 1281, 1393, 1503, 1613], '(T.S.K.);': [166, 278, 390, 502, 614, 726, 838, 950, 1062, 1172, 1282, 1394, 1504, 1614], 'Washington,': [171, 283, 395, 507, 619, 731, 843, 955, 1067, 1177, 1287, 1399, 1509, 1619], 'DC': [172, 284, 396, 508, 620, 732, 844, 956, 1068, 1178, 1288, 1400, 1510, 1620], '(G.R.M.);': [173, 285, 397, 509, 621, 733, 845, 957, 1069, 1179, 1289, 1401, 1511, 1621], 'Texas': [176, 288, 400, 512, 624, 736, 848, 960, 1072, 1182, 1292, 1404, 1514, 1624], 'Health': [177, 196, 289, 308, 401, 420, 513, 532, 625, 644, 737, 756, 849, 868, 961, 980, 1073, 1092, 1183, 1202, 1293, 1312, 1405, 1424, 1515, 1534, 1625, 1644, 2218], 'San': [179, 291, 403, 515, 627, 739, 851, 963, 1075, 1185, 1295, 1407, 1517, 1627], 'Antonio': [180, 292, 404, 516, 628, 740, 852, 964, 1076, 1186, 1296, 1408, 1518, 1628], '(S.R.N.);': [181, 293, 405, 517, 629, 741, 853, 965, 1077, 1187, 1297, 1409, 1519, 1629], 'Division': [182, 294, 406, 518, 630, 742, 854, 966, 1078, 1188, 1298, 1410, 1520, 1630], 'Biostatistics': [184, 296, 408, 520, 632, 744, 856, 968, 1080, 1190, 1300, 1412, 1522, 1632], 'Epidemiology,': [186, 298, 410, 522, 634, 746, 858, 970, 1082, 1192, 1302, 1414, 1524, 1634], 'Cincinnati,': [192, 223, 304, 335, 416, 447, 528, 559, 640, 671, 752, 783, 864, 895, 976, 1007, 1088, 1119, 1198, 1229, 1308, 1339, 1420, 1451, 1530, 1561, 1640, 1671], '(C.M.,': [194, 306, 418, 530, 642, 754, 866, 978, 1090, 1200, 1310, 1422, 1532, 1642], 'E.K.);': [195, 307, 419, 531, 643, 755, 867, 979, 1091, 1201, 1311, 1423, 1533, 1643], 'Care': [197, 309, 421, 533, 645, 757, 869, 981, 1093, 1203, 1313, 1425, 1535, 1645], 'Consultant,': [198, 310, 422, 534, 646, 758, 870, 982, 1094, 1204, 1314, 1426, 1536, 1646], '(L.E.P.);': [201, 313, 425, 537, 649, 761, 873, 985, 1097, 1207, 1317, 1429, 1539, 1649], 'Associates': [202, 314, 426, 538, 650, 762, 874, 986, 1098, 1208, 1318, 1430, 1540, 1650, 2231], 'Process': [204, 316, 428, 540, 652, 764, 876, 988, 1100, 1210, 1320, 1432, 1542, 1652, 2233], 'Improvement,': [205, 317, 429, 541, 653, 765, 877, 989, 1101, 1211, 1321, 1433, 1543, 1653], 'Austin,': [206, 318, 430, 542, 654, 766, 878, 990, 1102, 1212, 1322, 1434, 1544, 1654], 'TX': [207, 319, 431, 543, 655, 767, 879, 991, 1103, 1213, 1323, 1435, 1545, 1655], '(L.P.);': [208, 320, 432, 544, 656, 768, 880, 992, 1104, 1214, 1324, 1436, 1546, 1656], 'The': [210, 322, 434, 546, 658, 770, 882, 994, 1106, 1216, 1326, 1438, 1548, 1658, 1748, 1842, 2168, 3202, 3217, 3343], 'James': [211, 323, 435, 547, 659, 771, 883, 995, 1107, 1217, 1327, 1439, 1549, 1659, 2213], 'M.': [212, 324, 436, 548, 660, 772, 884, 996, 1108, 1218, 1328, 1440, 1550, 1660, 2214], 'Center': [214, 326, 438, 550, 662, 774, 886, 998, 1110, 1220, 1330, 1442, 1552, 1662, 2216, 2226], 'for': [215, 327, 439, 551, 663, 775, 887, 999, 1111, 1221, 1331, 1443, 1553, 1663, 1675, 1753, 1901, 1928, 1972, 2003, 2217, 2283, 2352, 2395, 2481, 2552, 2565, 2590, 2622, 2625, 2648, 2701, 2819, 2846, 2859, 2882, 2929, 2958, 2977, 2995, 3021, 3055, 3069, 3137, 3191, 3287, 3313, 3399, 3417, 3504, 3745, 3818], 'Clinical': [216, 328, 440, 552, 664, 776, 888, 1000, 1112, 1222, 1332, 1444, 1554, 1664], 'Excellence,': [217, 329, 441, 553, 665, 777, 889, 1001, 1113, 1223, 1333, 1445, 1555, 1665], '(C.L.).': [225, 337, 449, 561, 673, 785, 897, 1009, 1121, 1231, 1341, 1453, 1563, 1673], ',': [226, 338, 450, 562, 674, 786, 898, 1010, 1122, 1232, 1342, 1454], 'BeekmanIIIRobert': [229], 'BeekmanIII': [231], 'KuglerJohn': [341], 'Kugler': [343], 'RosenthalGeoffrey': [453], 'Rosenthal': [455], 'JenkinsKathy': [565], 'Jenkins': [567], 'KlitznerThomas': [677], 'Klitzner': [679], 'MartinGerard': [789], 'Martin': [791], 'NeishSteven': [901], 'Neish': [903], 'BrownDavid': [1013], 'Brown': [1015], 'MangeotColleen': [1124], 'Mangeot': [1125], 'KingEileen': [1234], 'King': [1235], 'PetersonLaura': [1345], 'Peterson': [1347], 'ProvostLloyd': [1456], 'Provost': [1457], 'LannonCarole': [1566], 'Lannon': [1567], 'Originally': [1683], 'published9': [1684], 'Jun': [1685], '2015https://doi.org/10.1161/CIRCOUTCOMES.115.001956Circulation:': [1686], 'Outcomes.': [1690], '2015;8:428–436Other': [1691], 'version(s)': [1692], 'this': [1694, 1703, 1846, 1874, 2166, 3461, 3514, 3715, 3974], 'articleYou': [1695], 'are': [1696, 1743, 1984, 2256, 2720, 2901, 3101, 3422, 3431, 3435, 3447, 3451, 3470, 3500, 3517, 3686, 3888], 'viewing': [1697], 'most': [1699], 'recent': [1700, 1814], 'version': [1701], 'article.': [1704], 'Previous': [1705, 1710], 'versions:': [1706], 'January': [1707], '1,': [1708], '2015:': [1709], 'Version': [1711], '1': [1712, 2576, 3167], 'Goals': [1713], 'Vision': [1715], 'ProgramInfants': [1718], 'with': [1719, 1727, 1755, 1759, 1764, 1786, 1893, 1903, 2005, 2117, 2184, 2204, 2302, 2630, 2635, 2665, 2672, 2685, 2693, 2727, 2734, 2748, 2756, 2773, 2780, 2796, 2799, 2807, 2831, 2840, 2867, 2876, 2909, 2918, 2937, 2947, 2966, 3003, 3011, 3041, 3132, 3293, 3355, 3385, 3396, 3562, 3617, 3777, 3801, 3950, 3971, 3988], 'univentricular': [1720, 1757, 1904, 1977, 2011, 3387, 3819], 'congenital': [1721, 3235], 'heart': [1722, 1730, 1905, 1978, 2194, 2544], 'disease': [1723], '(CHD),': [1724], 'including': [1725, 2139], 'those': [1726, 2476], 'hypoplastic': [1728], 'left': [1729], 'syndrome': [1731], '(HLHS),': [1732], 'regularly': [1733, 3901], 'pose': [1734], 'dilemmas': [1735], 'decision-making': [1737], 'because': [1738], 'their': [1739, 2443, 2456, 2467, 3412, 3426, 3443, 3465, 3908], 'anatomy': [1740, 1758], 'physiology': [1742], 'often': [1744], 'unique': [1745], 'variable.': [1747], 'typical': [1749], 'staged': [1750, 3816], 'surgical': [1751, 1799, 3507, 3848, 3856, 3868], 'course': [1752, 2654], 'infants': [1754, 3384, 3722, 3836, 3884], 'complex': [1756, 2342], 'systemic': [1760], 'outflow': [1761], 'obstruction': [1762], 'begins': [1763], 'Norwood': [1766, 1819, 1908, 2521, 2613, 2713, 3127, 3392, 3427], '(stage': [1767, 1783], '1)': [1768], 'operation': [1769, 1793, 1909], 'or': [1770, 2031, 2036, 2541, 2816, 2843, 3106, 3394, 3496, 3583], 'variant': [1771, 3395], 'shortly': [1772], 'after': [1773, 1817, 1906, 2245, 2520, 2681, 2712, 2744, 2769, 2792, 2826, 3165], 'birth,': [1774], 'followed': [1775], 'several': [1776, 1794, 1936, 3198], 'months': [1777], 'later': [1778], 'by': [1779, 1859, 2201, 3688, 3874], 'superior': [1780], 'cavopulmonary': [1781], 'anastomosis': [1782], '2': [1784, 1824, 2527, 3402, 3506], 'palliation)': [1785], 'an': [1787, 2392, 2841, 3230, 3526], 'ultimate': [1788, 3397], 'goal': [1789, 1895], 'Fontan-type': [1792], 'years': [1795], 'later.1–3': [1796], 'postoperative': [1801], 'management': [1802, 1996, 2850], 'has': [1803, 1833, 1848, 3664, 3788, 3828, 3926], 'led': [1804], 'considerable': [1806], 'improvement': [1807, 2263, 2387, 3089, 3376, 3910, 3999], 'early': [1809], 'post-Norwood': [1810], 'survival': [1811, 1857], 'era.4–7': [1815], 'However,': [1816, 3841, 3969, 3987], 'procedure': [1820, 3393], 'before': [1822, 1945], 'stage': [1823, 2526, 3166, 3401, 3505], 'palliation,': [1825], 'high-risk': [1827], 'time': [1828, 3162, 3459, 3613, 3708], 'period': [1829], 'termed': [1830], 'interstage,': [1831], 'mortality': [1832, 1872, 3092], 'been': [1834, 1836, 2369, 3665, 3829, 3859, 3927], 'previously': [1835], 'reported': [1837], '10%': [1839], '15%.8–10': [1841], 'rare': [1843, 1973, 2337, 3564, 3712], 'nature': [1844], 'disorder': [1847], 'limited': [1849], 'robust': [1850], 'learning': [1851, 1886, 2019, 2110, 2242, 2250, 2486], 'about': [1852, 2357, 2404, 2498, 3383, 3492], 'successful': [1853], 'strategies': [1854], 'improve': [1856, 1871, 1914, 2277, 2298, 2455], 'undertaken': [1858], 'single-surgical': [1860], 'centers,': [1861], 'gap': [1864], 'exists': [1865], 'our': [1867], 'ability': [1868, 3576], 'further': [1870], 'population.The': [1875], '(NPC-QIC),': [1882], 'first': [1884], 'multicenter': [1885], 'network': [1887, 2111, 2480, 3787], 'within': [1888], 'pediatric': [1889, 2376, 3233, 3556], 'cardiology,11': [1890], 'was': [1891, 2015, 2022, 2048, 2079, 2125, 2145, 3033, 3206, 3225, 3337, 3773], 'established': [1892, 2370], 'improving': [1897], 'care': [1898, 2132, 2288, 2320, 2351, 2374, 2439, 2688, 2834, 2870, 3062, 3099, 3110, 3113, 3152, 3158, 3581, 3919], 'outcomes': [1900, 1944, 2107, 2324], 'children': [1902, 2004], 'specifically': [1911], '(1)': [1913, 3109], 'interstage': [1915, 1919, 1925, 2563, 2577, 2657, 2860, 2930, 2959, 2996, 3022, 3056, 3091, 3116, 3148, 3173, 3445, 3489, 3494, 3727, 3743, 3771], 'mortality,': [1916, 2077], '(2)': [1917, 3112], 'decrease': [1918], 'growth': [1920, 2632, 2636, 2640, 2967, 3831], 'failure,': [1921], '(3)': [1923, 3115], 'reduce': [1924, 2327], 'hospital': [1926, 3486], 'readmissions': [1927, 2564], 'major': [1929, 1992, 2567, 2598], 'medical': [1930, 2338], 'events.Local': [1931], 'Challenges': [1932], 'ImplementationThere': [1934], 'were': [1935, 2064, 2178, 2550, 2588, 3078, 3200], 'perceived': [1937], 'challenges': [1938, 2099, 2169, 2200], 'success': [1940], 'changing': [1942, 2034], 'clinical': [1943, 1982, 2055, 2068, 2131, 2159, 2287, 2295, 2323, 2469, 2499, 3082, 3140, 3256, 3346, 3473], 'starting': [1946], 'NPC-QIC': [1948, 2142, 2463, 2511, 3205, 3245, 3266, 3289, 3303, 3379, 3689, 3717, 3770, 4025], 'collaborative.': [1949, 3260], 'A': [1950, 2045, 2639, 3796], 'primary': [1951, 2802, 2811, 3061, 3157], 'challenge': [1952, 2047, 3573, 3929], 'collaboration': [1954], 'among': [1955, 1998, 3993], 'multiple': [1956], 'sites': [1957, 3410, 3594, 3792, 3857, 3876], 'can': [1958], 'be': [1959, 1966, 2029, 2042, 2072, 2128, 2151, 2333, 3086, 3964], 'agreement': [1960], 'on': [1961, 2261, 2310, 2391, 2435, 2506, 3139, 3220, 3309, 3502, 3748, 3973], 'best': [1962], 'practices': [1963, 1997, 2035, 2069, 2092, 2177, 3083, 3992], 'that': [1964, 2112, 2130, 2148, 2259, 2717, 2862, 2898, 2932, 2961, 2998, 3024, 3058, 3143, 3512, 3676, 3814, 3880, 3960, 3981], 'should': [1965], 'implemented.': [1967], 'This': [1968, 3242, 3248, 3547], 'is': [1969, 2239, 2348, 2389, 2643, 2988, 3475, 3548, 3978], 'especially': [1970, 2334], 'true': [1971], 'diseases,': [1974, 3565], 'such': [1975, 2340], 'as': [1976, 2017, 2341, 2473, 2475, 2645, 3229, 3304, 3350, 3352], 'disease,': [1979, 2380], 'where': [1980, 2344, 2714, 2895, 2974, 3029, 3073], 'evidence-based': [1981], 'guidelines': [1983], 'not': [1985, 3448, 3452, 3979], 'available': [1986, 3339], 'clinicians.': [1988], 'As': [1989, 3561], 'noted': [1990], 'above,': [1991], 'variation': [1993, 2285], 'persists': [1994], 'individuals': [1999], 'institutions': [2001, 3369], 'caring': [2002], 'HLHS': [2006, 3570, 3905], 'other': [2008], 'forms': [2009], 'CHD.8,12–16': [2012], 'Although': [2013, 2057], 'NPC': [2014], 'designed': [2016], 'collaborative,': [2020, 2086, 2138], 'it': [2021, 2078, 2124, 2149, 3808, 3925], 'unclear': [2023, 2080], 'whether': [2024, 2037, 2087], 'teams': [2025, 2133, 2160, 2419, 2432, 2490, 3195, 3274, 3286, 3371, 3920, 3941, 4026], 'caregivers': [2027], 'would': [2028, 2039, 2093, 2113, 2150, 2161, 3961], 'willing': [2030], 'interested': [2032], 'there': [2038, 3663, 3827], 'continue': [2040], 'persistent': [2043], 'variation.': [2044], 'second': [2046], 'linkage': [2050], 'between': [2051, 2518, 2555, 2593, 2612, 2633, 3232, 3711, 3728], 'process': [2052, 2208, 2500, 3582], 'measures': [2053], 'outcomes.': [2056, 2278], 'expert': [2058, 3076], 'opinion': [2059, 3077], 'literature': [2061], '(where': [2062], 'available)': [2063, 3074], 'used': [2065, 3079, 3687], 'design': [2067], 'expected': [2070, 2098, 3084], 'related': [2073, 3087], 'reduction': [2075], 'onset': [2083], 'adherence': [2088, 2102], 'these': [2090], 'specific': [2091], 'indeed': [2094], 'move': [2095], 'mortality.': [2096, 3497], 'We': [2097, 2196, 3912, 3946], 'measuring': [2101, 2106], 'processes': [2104, 2321, 2470, 3100, 3123], 'have': [2114, 2162, 2367, 3858, 3913, 3947, 3984, 3996], 'rolling': [2115, 3803], 'enrollment': [2116], 'new': [2118], 'centers': [2119, 2314, 2415, 3813, 3869, 3887, 3899], 'joining': [2120], 'each': [2121, 3479, 3493, 3932, 3967], 'year.': [2122], 'Finally,': [2123, 3498, 3752], 'felt': [2126], 'essential': [2129], 'actively': [2134], 'participate': [2135, 2416, 2445], 'attending': [2140], 'face-to-face': [2141], 'meetings.': [2143], 'There': [2144], 'some': [2146], 'concern': [2147], 'difficult': [2152], 'gain': [2154, 2611, 2983], 'institutional': [2155], 'buy-in': [2156, 2172, 3192, 3373], 'locally,': [2157], 'so': [2158], 'support': [2163, 2410], 'do': [2165], 'work.': [2167, 3911], 'team': [2171, 3264, 3933], 'implementation': [2174], 'change': [2176, 2408, 3668], 'primarily': [2179], 'addressed': [2180, 2197], 'building': [2181], 'program': [2183], 'engagement': [2185, 3344], 'national': [2187, 2363, 3213, 3252], 'leaders': [2188, 3347], 'field': [2191], 'congential': [2193], 'disease.': [2195], 'measurement': [2199, 3674], 'working': [2202, 2274, 3970], 'closely': [2203, 3949], 'experts': [2205, 3214], 'statistical': [2207, 3588, 3597, 3642, 3680], 'control': [2209, 3648, 3681], '(SPC)': [2210], 'from': [2211, 2462, 3193, 3425, 3464, 3478, 3592], 'Systems': [2219], 'Excellence': [2220], 'consultant': [2229], 'firm': [2230], 'Improvement.Design': [2234], 'InitiativeConceptual': [2237], 'ModelNPC-QIC': [2238], 'longitudinal': [2241], 'community': [2243], 'modeled': [2244], 'Institute': [2247, 2394], 'Medicine': [2249], 'healthcare': [2251], 'system': [2252, 3312, 3646, 3671, 3692, 3764, 3866], 'framework.17': [2253], 'These': [2254, 3098, 3694], 'networks': [2255, 2301, 2331, 2364], 'multisite': [2257], 'collaborations': [2258], 'focus': [2260], 'both': [2262], 'research': [2265], 'engage': [2267, 3937], 'patients,': [2268], 'families,': [2269], 'clinicians,': [2270], 'researchers': [2272], 'together': [2275, 2493], 'They': [2279], 'provide': [2280, 2304], 'resource': [2282], 'understanding': [2284], 'opportunities': [2290], 'test': [2292, 2452], 'changes': [2293, 2453, 3579, 3606, 3643, 3761], 'practice': [2296, 2411], 'care.': [2299], 'Large': [2300], 'registries': [2303], 'infrastructure': [2306], 'gather': [2308], 'information': [2309, 2818, 3032, 3382, 3474, 3491], 'patients': [2311, 2548, 2556, 2571, 2586, 2594, 2620, 2629, 2634, 2678, 2709, 2741, 2766, 2789, 2823, 3429, 3633, 3906, 4029], 'across': [2312], 'treatment': [2313], 'understand': [2317, 2373], 'differences': [2318, 3601], 'unnecessary': [2328], 'variation.18–20': [2329], 'may': [2332, 3144], 'useful': [2335], 'problems,': [2339], 'CHD,': [2343], 'no': [2345], 'one': [2346], 'center': [2347], 'able': [2349], 'enough': [2353], 'cases': [2354], 'learn': [2356], 'potential': [2358], 'optimal': [2359], 'practices.': [2360], 'Regional': [2361], 'databases': [2366], 'also': [2368, 3291], 'better': [2372], 'cancer,': [2377], 'inflammatory': [2378], 'bowel': [2379], 'neonatal': [2381], 'management,': [2382], 'cystic': [2384], 'fibrosis.21–24Improvement': [2385], "MethodologyNPC-QIC's": [2386], 'method': [2388], 'based': [2390], 'adapted': [2393], 'Healthcare': [2396], "Improvement's": [2397], 'Breakthrough': [2398], 'Series': [2399], 'Model,': [2400], 'which': [2401, 3650], 'incorporates': [2402], 'knowledge': [2403], 'dissemination': [2405], 'behavior': [2407], 'change.25': [2412], 'cardiology': [2414, 3557], 'through': [2417], 'local': [2418, 2468, 3194, 3263, 3273, 3909, 3922, 4005], 'comprised': [2420], 'physician': [2423, 3159], 'champion,': [2424], 'nursing,': [2425], 'nutrition,': [2426], 'family': [2428], 'representatives.': [2429], 'Each': [2430, 2507], 'month,': [2431], 'submit': [2433], 'data': [2434, 3463, 3499, 3591, 3626], 'patient': [2436, 3744], 'status': [2437, 2696, 2879], 'processes;': [2440], 'postreports': [2441], 'progress;': [2444], 'webinars': [2447], 'listserv;': [2450], 'systems.': [2457], 'Teams': [2458], 'receive': [2459], 'monthly': [2460, 3750], 'reports': [2461], 'demonstrating': [2464], 'results': [2465], 'outcomes,': [2472], 'well': [2474, 3351], 'entire': [2479, 3444], 'benchmarking': [2482], '(Table': [2483], '1).': [2484, 3097], 'Semiannual': [2485], 'session': [2487], 'workshops': [2488], 'bring': [2489], 'parents': [2492, 2535, 3903, 3938, 3959, 3972], 'share': [2495], 'lessons': [2496], 'learned': [2497], 'changes.Table': [2501], '1.': [2502, 3178], 'Key': [2503], 'Metrics': [2504], 'Reported': [2505], 'Patient': [2508], 'RegistryMeasureGoalData': [2512], 'DefinitionsMortality0%Numerator:': [2513], 'cumulative': [2514, 2532, 3701], 'no.': [2515, 2533, 2561, 2569, 2618, 2669, 2676, 2690, 2707, 2731, 2739, 2753, 2764, 2777, 2787, 2804, 2821, 2836, 2855, 2872, 2888, 2914, 2925, 2943, 2954, 2970, 2991, 3007, 3017, 3037, 3051], 'deaths': [2517], 'discharge': [2519, 2614, 2659, 2667, 2674, 3128, 3164], 'repair': [2522, 2528], 'completion': [2524], '(ie,': [2529], 'interstage)Denominator:': [2531], 'who': [2536, 2549, 2557, 2572, 2587, 2595, 3389, 3430, 3441, 3723], 'had': [2537, 2542, 2573, 2596, 3914, 3997], 'Glenn,': [2539], 'died,': [2540], 'transplantMortality': [2545], 'G·chart***No.': [2546], 'admitted': [2551, 2589, 2621], 'glenn': [2553], 'surgery': [2554, 2592, 3466], 'diedMajor': [2558], 'event': [2559, 2582, 2599, 2642], 'readmission0%Numerator:': [2560], 'eventDenominator:': [2568], 'least': [2575], 'day': [2578], 'n': [2579], 'month/100Major': [2581], 'G': [2583, 3696, 3705], 'chart***No.': [2584], 'Glenn': [2591, 2616, 2623, 2661], 'readmissionAverage': [2600], 'daily': [2601, 2609, 2981], 'weight': [2602, 2610, 2976, 2982], 'gain90%Numerator:': [2603], 'number': [2604, 3720, 3834, 4023], 'achieving': [2605], 'minimum': [2607], 'age-appropriate': [2608], 'admissionDenominator:': [2617], 'surgeryWeight': [2624], 'length': [2626, 2649], 'achievement***No.': [2627], 'adequate': [2631], 'failure': [2637, 2641], 'events.': [2638, 3713], 'defined': [2644], 'decreasing': [2646], '≥2Weight': [2647], 'percentile': [2650], 'bands': [2651], 'over': [2652, 3607, 3765, 4007], '(Norwood': [2658], 'admission)Proportion': [2662], 'discharges': [2664, 2671, 2684, 2692, 2726, 2733, 2747, 2755, 2772, 2779, 2795, 2806], 'identified': [2666, 2673, 2808, 2810, 2832, 2845], 'coordinator100%Numerator:': [2668, 2835], 'coordinatorDenominator:': [2675], 'discharged': [2679, 2710, 2742, 2767, 2790, 2824, 3423], 'alive': [2680, 2711, 2743, 2768, 2791, 2825], 'NorwoodProportion': [2682, 2745, 2770, 2793, 2827], 'complete': [2686, 3725], 'preventative': [2687, 2869], 'plan100%Numerator:': [2689, 2776, 2871, 2942, 3006], 'documented': [2694, 2877, 3042], 'immunization': [2695, 2878], 'discharge,': [2698, 3462], 'plan': [2700, 2760, 2783, 2798, 2881, 2951, 3014, 3136, 3153, 3398], 'RSV': [2702, 2883], 'influenza': [2704, 2885], 'prevention': [2705, 2886], 'discussedDenominator:': [2706, 2887], 'site': [2715, 2896, 3521, 3849], 'indicates': [2716, 2897, 3060], 'routine': [2718, 2899], 'immunizations': [2719, 2900], 'recommended': [2721, 2902], 'during': [2722, 2892, 2903, 3487], 'interstageProportion': [2724, 2905], 'written': [2728, 2735, 2749, 2757, 2774, 2781, 2911, 2920, 2939, 3134], 'medication': [2729, 2736, 2912, 2921], 'list100%Numerator:': [2730, 2913], 'list': [2737, 2922], 'providedDenominator:': [2738, 2923, 2952, 3015], 'Red-Flag': [2750], 'Action': [2751], 'Plan100%Numerator:': [2752], 'red-flag': [2758, 2940, 2949], 'action': [2759, 2941, 2950, 3135], 'provided': [2761, 2784], 'familiesDenominator:': [2763, 2786], 'nutrition': [2775, 2782, 3005, 3013], 'follow-up': [2797], 'PCP': [2800, 3045], 'cardiologist100%Numerator:': [2803], 'PCP,': [2809], 'cardiologist,': [2812], 'scheduled': [2814], 'appointments': [2815], 'contact': [2817], 'self-schedulingDenominator:': [2820], 'clinic': [2829, 2838, 2857, 2865, 2874, 2890, 2907, 2916, 2927, 2935, 2945, 2956, 2964, 2972, 2993, 3001, 3009, 3019, 3027, 3030, 3039, 3047, 3053, 3174], 'visits': [2830, 2839, 2858, 2866, 2875, 2891, 2908, 2917, 2928, 2936, 2946, 2957, 2965, 2973, 2994, 3002, 3010, 3020, 3028, 3040, 3054], 'postclinic': [2833], 'individual': [2842, 3593], 'group': [2844, 3211, 3243, 3779], 'coordinating': [2847], 'outpatient': [2849, 3480], 'patientDenominator:': [2853], 'total': [2854, 2924, 2953, 2990, 3016, 3050], 'population': [2861, 2931, 2960, 2997, 3023, 3057, 3636], 'monthProportion': [2863, 2933, 2962, 2999, 3025], 'updated': [2868, 2910, 2919, 2938, 2948, 3004, 3012, 3171], 'month': [2894], 'parameter': [2968], 'documentation100%Numerator:': [2969], 'weight,': [2975], 'age': [2978], 'percentile,': [2979], 'average': [2980], 'current': [2985], 'caloric': [2986], 'intake': [2987], 'documentedDenominator:': [2989], 'visit': [3031, 3048, 3481], 'communicated': [3034], 'PCP100%Numerator:': [3036], 'communication': [3043], 'informationDenominator:': [3049], 'monthPCP': [3059], 'physician;': [3063], 'RSV,': [3065], 'respiratory': [3066], 'syncytial': [3067], 'virus.Theory': [3068], 'Mortality': [3070], 'ImprovementEvidence': [3071], '(literature,': [3072], 'identify': [3081, 3673, 3691, 3958], '(key': [3093], 'driver': [3094, 3187], 'diagram:': [3095], 'Figure': [3096], 'grouped': [3102], 'into': [3103, 3525], '4': [3104, 3335, 3854], 'domains': [3105], 'key': [3107, 3186], 'drivers:': [3108], 'coordination,': [3111], 'transitions,': [3114], 'growth,': [3117], '(4)': [3119], 'engaging': [3120, 3918], 'families.': [3121], 'Example': [3122], 'include': [3124, 3276, 3695], 'applying': [3125], 'standard': [3126], 'procedures,': [3129], 'providing': [3130], 'families': [3131], 'acting': [3138], 'Red': [3141], 'Flags': [3142], 'arise': [3145], 'communicating': [3150], "infant's": [3156], 'palliation': [3168, 3508, 3817], 'when': [3170, 3420, 3662, 3845], 'visits.Download': [3175], 'figureDownload': [3176, 4009], 'PowerPointFigure': [3177, 4010], '(NPC-QIC)': [3185], 'diagram.To': [3188], 'address': [3189], 'concerns': [3190], 'institutions,': [3197], 'steps': [3199], 'taken.': [3201], 'leadership': [3203, 3249, 3267, 3290], 'made': [3207, 3268, 3338], 'up': [3208], 'CHD.': [3216], 'Joint': [3218], 'Council': [3219], 'Congenital': [3221], 'Disease': [3223], '(JCCHD)': [3224], 'formed': [3226], '2003': [3228], 'alliance': [3231], 'cardiologists,': [3234], 'cardiothoracic': [3236], 'surgeons,': [3237], 'adult': [3239], 'CHD': [3240, 3388, 3820], 'specialists.': [3241], 'founded': [3244], '2006.': [3247], 'level': [3253, 3522, 4006], 'gave': [3254], 'instant': [3255], 'credibility': [3257], 'At': [3261, 3457], 'level,': [3265], 'point': [3270, 3308], 'encourage': [3272], 'clinician': [3277], 'parent': [3279, 3952, 4001], 'involvement,': [3280], 'allowing': [3281, 3622], 'parental': [3282], 'voice': [3283], 'push': [3285], 'improvement.': [3288], 'worked': [3292, 3948], 'US': [3294, 3356], 'News': [3295, 3357], 'World': [3297], 'Report': [3298], 'add': [3300], 'involvement': [3301, 3367, 4002], 'line': [3306], 'item': [3307], 'scoring': [3311], 'Cardiac': [3314], 'Cardiothoracic': [3316], 'Surgery': [3317], 'Programs,': [3318], 'increasing': [3319], 'value': [3321], 'institutions.': [3323], 'In': [3324, 3714], 'addition,': [3325], 'American': [3327, 3360], 'Board': [3328, 3361], 'Pediatrics': [3330], 'Maintenance': [3331], 'Certification': [3333], 'Part': [3334], 'credit': [3336], 'participating': [3341, 3409, 3875, 3886], 'physicians.': [3342], 'parents,': [3349], 'alignment': [3354], 'Pediatrics,': [3363], 'helped': [3364], 'drive': [3365], 'quality': [3375], 'activities.Data': [3377], 'CollectionThe': [3378], 'registry': [3380, 3418, 3528], 'captures': [3381], 'undergo': [3390], 'palliation.': [3403], 'Institutional': [3404], 'Review': [3405], 'Boards': [3406], 'all': [3408, 3563], 'approved': [3411], 'participation.': [3413], 'Infants': [3414], 'become': [3415], 'eligible': [3416, 3432, 3449, 3883], 'inclusion': [3419], 'they': [3421], 'home': [3424], 'surgery;': [3428], 'consented': [3434, 3889], 'enrolled': [3436, 3837], 'registry.': [3439, 3456, 3840, 3894], 'Patients': [3440], 'spend': [3442], 'hospitalized': [3446], 'included': [3453, 3891], 'initial': [3468], 'hospitalization': [3469, 3511], 'captured.': [3471], 'Additional': [3472], 'then': [3476], 'collected': [3477, 3501, 3518], 'readmission': [3483], 'transplantation': [3495], 'admission': [3503], 'follows': [3513], 'surgery.': [3515, 3560], 'Data': [3516, 3533, 3799], 'entered': [3524], 'electronic': [3527], 'using': [3529, 3586, 3647], 'Research': [3531], 'Electronic': [3532], 'Capture': [3534], 'system.Statistical': [3535], 'MethodologyNPC-QIC': [3536], 'uses': [3537], 'SPC': [3538, 3609, 3639, 3684], 'methods': [3539, 3610, 3616], 'charts': [3541, 3640, 3685, 3706, 3731], 'measure': [3543, 3578, 3600], 'report': [3545, 3900], 'progress.': [3546], 'novel': [3550], 'approach': [3551], 'fields': [3554], 'cardiac': [3559], 'low': [3567], 'incidence': [3568], 'presents': [3571], 'outcome': [3584], 'performance': [3585], 'traditional': [3587], 'methods.26': [3589], 'Combining': [3590], 'improves': [3595], 'power': [3598], 'effects': [3604], 'time.': [3608], 'combine': [3611], 'rigorous': [3612], 'series': [3614], 'analysis': [3615], 'graphical': [3618], 'presentation': [3619], 'data,': [3621], 'meaningful': [3623, 3944], 'interpretation': [3624], 'despite': [3627], 'relatively': [3629], 'small': [3630, 3760], 'numbers': [3631], 'interest.27–29': [3638], 'document': [3641, 3732], 'limits,': [3649], 'define': [3651], '3': [3652], 'SDs': [3653], 'above': [3654], 'below': [3656], 'mean.': [3658], 'Statistical': [3659], 'rules': [3660], 'determine': [3661], 'significant': [3667], 'points': [3675], 'fall': [3677], 'outside': [3678], 'limits.': [3682], 'Several': [3683], 'changes.': [3693], 'charts,': [3697, 3699], 'P': [3698, 3730], 'sum': [3702], '(CuSum)': [3703], 'charts.': [3704], 'track': [3707], 'distance': [3710], 'case,': [3716], 'tracks': [3718], 'successfully': [3724], 'mortalities.': [3729], 'percentage': [3733, 3739], 'events,': [3735], 'here': [3736], 'tracking': [3737], 'mortalities': [3741], 'per': [3742], 'collaborative': [3747], 'basis.': [3751], 'CuSum': [3754], 'chart': [3755], 'determines': [3756], 'accumulation': [3758], 'time.Implementation': [3766], 'InitiativeThe': [3769], 'project': [3772, 3977], 'implemented': [3774], '2008': [3776], '6': [3781], 'pilot': [3782], 'sites.': [3783], 'Since': [3784, 3825], 'then,': [3785], 'grown': [3789], '55': [3791], '(Figure': [3793], '2;': [3794], 'Appendix': [3795], 'Supplement)': [3800], 'onboarding': [3804], 'system,': [3805], 'now,': [3807], 'includes': [3809], 'majority': [3811], 'perform': [3815], 'United': [3823], 'States.': [3824], '2008,': [3826], 'steady': [3830, 3998], 'since': [3842, 3870], 'October': [3843], '2012': [3844], '50th': [3847], 'joined': [3850], 'network,': [3852], 'only': [3853], 'additional': [3855], 'added,': [3860], 'leading': [3861], 'fairly': [3864], 'stable': [3865], 'late': [3871], '2012.': [3872], 'Self-audits': [3873], 'twice': [3877], 'yearly': [3878], 'indicate': [3879], '>95%': [3881], 'Over': [3895], 'half': [3896], '(54%)': [3897], 'involving': [3902], 'few': [3915], 'barriers': [3916], 'sites,': [3923, 3994], 'but': [3924], 'get': [3931], 'find': [3935], 'way.': [3945], 'group,': [3953], 'Sisters': [3954], 'By': [3955], 'Heart,': [3956], 'like': [3962], 'involved': 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