Download Link

SECTION E: PEDIATRIC AND CONGENITAL CARDIOLOGY/CARDIOTHORACIC
SURGERY
E1.
Do you have a Pediatric and Congenital Cardiology/Cardiothoracic Surgery program?
 Yes – Go to Question E2
 No – Skip to Section F
REQUIRED: IF E1=BLANK, DISPLAY: “E1: A response is required for this question prior to
submitting the survey. Click “OK” to continue with the survey and answer this
question later. Click “Cancel” to provide a response to this question now.”
When responding to questions in this section, we recommend that you consult with the medical
director of your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program(s) to ensure
accurate answers that are consistent with the intent of the survey.
As data are reviewed, U.S. News may have questions about responses to individual questions or
about an entire submission. To ensure communication with the appropriate clinical leader, please
provide the following information about the chief of service (or equivalent) for your Pediatric and
Congenital Cardiology/Cardiothoracic Surgery program.
Full name:
Title:
Email:
Preferred phone:
REQUIRED: IF NAME, TITLE, EMAIL, OR PHONE=BLANK, DISPLAY: “A response is
required for [Name/Title/Email/Phone] prior to submitting the survey. Click “OK”
to continue with the survey and answer this question later. Click “Cancel” to
provide a response to this question now.”
Last updated: 1/30/2017
E2.
Please indicate the total number of attending/on-staff physicians (excluding fellows)1 who
are currently members of the medical staff in your Pediatric and Congenital
Cardiology/Cardiothoracic Surgery program in the following categories. For each
category, please indicate the total number of full-time equivalents (FTEs)2 devoted to
clinical care. [If none, please enter 0.]
Total
Clinical
Physicians
FTEs
a. Pediatric cardiothoracic surgeons (include only board
certified/board eligible by the American Board of
Thoracic Surgery or equivalent for surgeons trained
outside the US, with a fellowship or other training in
pediatric and congenital heart surgery)
________
________
b. Pediatric cardiac intensivists: Cardiologist - board
certified/board eligible in Pediatrics by the American
Board of Pediatrics, with subspecialty
certification/eligibility in Pediatric Cardiology, plus
1 year of additional specific training in pediatric cardiac
intensive care, or > 10 years of experience as a dedicated
pediatric cardiac intensivist.
________
________
c. Pediatric cardiac intensivists: Pediatric Critical Care board certified/board eligible in Pediatrics by the
American Board of Pediatrics, with subspecialty
certification/eligibility in Pediatric Critical Care, plus 1
year of additional specific training in pediatric cardiac
intensive care (additional subspecialty certification in
Pediatric Cardiology satisfies this requirement), or > 10
years of experience as a dedicated pediatric cardiac
intensivist.
________
________
d. Pediatric cardiac intensivists: Anesthesiologist - board
certified/board eligible in Anesthesia by the American
Board of Anesthesia, with at least 6 months of additional
training in pediatric cardiac anesthesia, and 1 year of
additional training in pediatric cardiac intensive care, or
> 10 years of experience as a dedicated pediatric cardiac
intensivist.
________
________
1
Attending/on-staff physicians include those who have completed their training in their particular medical specialty, are actively
providing clinical care to patients, and are currently considered a member of the “medical staff” at the hospital. This may include
physicians employed by the hospital, an affiliated university, or some other entity as long as the physician is considered part of
the medical staff at the hospital.
2 To calculate physician clinical FTEs, please take the percentage of typical clinical effort that a physician provides to the
program and divide by 100. This resulting decimal will be the clinical FTE for this physician. For example, Dr. A spends 75%
of his time in clinical care and 25% in research; the clinical FTE for Dr. A would be 0.75 FTE (i.e., 75/100=0.75). If a clinician
divides his or her clinical time in different areas, count only the proportion of time spent in the relevant clinical area. (For
example, if a clinician is 80% clinical but spends half of that time as a Pediatric cardiac interventionalists and half of that time as
a Pediatric cardiac intensivist, please count this clinician as 0.4 FTE as a Pediatric cardiac interventionalists 0.4 FTE as a
Pediatric cardiac intensivist.)
Last updated: 1/30/2017
e.
f.
g.
h.
Pediatric cardiac interventionalists - board
certified/board eligible in pediatrics by the American
Board of Pediatrics, with subspecialty
certification/eligibility in pediatric cardiology, and 1year additional specific training in pediatric cardiac
intervention, or > 10 years of experience as a dedicated
pediatric cardiac interventionalist.
Pediatric cardiac electrophysiologists - board
certified/board eligible in pediatrics by the American
Board of Pediatrics, with subspecialty
certification/eligibility in pediatric cardiology, and 1year additional specific training in pediatric cardiac
electrophysiology, or > 10 years of experience as a
dedicated pediatric cardiac electrophysiologist
Anesthesiologist - board certified/board eligible in
Anesthesia by the American Board of Anesthesia, with at
least 12 months of additional training in pediatric
anesthesia or board certification/board eligible in
pediatric anesthesia, and at least 6 months additional
training pediatric cardiac anesthesia, or > 10 years of
experience as a dedicated pediatric cardiac
anesthesiologist.
Board certified pediatric radiologists who participate in a
multidisciplinary institutional heart center program
________
________
________
________
________
________
________
________
VALIDATE: IF E2x1 IS NOT A WHOLE NUMBER, DISPLAY: “E2x (Total Physicians): Please
enter a whole number (no decimals).”
E2.1
How many of the surgeons listed in E2a also have obtained Subspecialty Certification in
Congenital Heart Surgery from the American Board of Thoracic Surgery (ABTS)? [If none,
please enter 0.]
________ Number of surgeons with subspecialty certification
VALIDATE: IF E2.1 IS NOT A WHOLE NUMBER, DISPLAY: “E2.1 (Total Physicians): Please
enter a whole number (no decimals).”
Note: The preceding questions are used to determine eligibility for Pediatric & Congenital
Cardiology/Cardiothoracic Surgery. If you leave any part of these questions blank, your hospital will
be considered ineligible for the rankings in Pediatric and Congenital Cardiology/Cardiothoracic
Surgery.
Last updated: 1/30/2017
E3.
Does your center provide 24-hour in-house coverage every day to the cardiac-specific ICU3
with providers who are trained in the management of congenital heart disease and can
provide immediate evaluation and intervention for critical cardiac issues, such as an
emergency echocardiogram and pericardiocentesis (any method of 24-hour in-house
echocardiography support is acceptable)?
 Yes, in a dedicated Cardiac ICU (CICU) – Go to Question E3.1
 Yes, in a dedicated section of a Pediatric ICU (PICU) and/or Neonatal ICU (NICU) – Go to
Question E3.1
 Yes, in a blended Pediatric ICU (PICU) and/or Neonatal ICU (NICU) without a dedicated
section – Go to Question E3.1
 No (none of the above) – Skip to Question E4
E3.1
If yes to E3, which of the following in-house4 coverage options does your center
provide for nights and weekends? (Check all that apply.)
□
□
□
□
□
Attending coverage by pediatric cardiac intensivists as defined in question E2b, E2c or E2d
Attending coverage by pediatric intensivists, who do not meet the criteria in question E2b,
E2c or E2d, but regularly cover the cardiac ICU patients
Pediatric cardiology, pediatric cardiac intensive care, or pediatric cardiac surgery trainees,
with back-up off-site by attendings who regularly cover the cardiac ICU during the day
Non-physician advanced practitioners who are dedicated to cardiac intensive care
management, with back-up off-site by attendings who regularly cover the cardiac ICU during
the day
Other staff offering coverage (please specify below)
E3.2
If you selected “other” in E3.1, please describe the staff that provide coverage and
any off-site support that they receive from attendings or other medical staff from
the cardiology and cardiothoracic surgery program at your hospital:
3
A CICU is a specialized unit designed to meet the needs of pediatric cardiac patients, including (a) newborns diagnosed with
critical congenital heart disease, (b) infants and children with congenital or acquired heart disease, (c) infants and children with
arrhythmias, (d) candidates for heart transplantation, and (e) patients with heart disease who require intensive care services
following noncardiac surgery. The CICU is staffed with a multidisciplinary care team, including cardiac intensivists,
cardiothoracic surgeons, and dedicated cardiac nurses. “Dedicated” indicates the beds and staff are used exclusively for
cardiothoracic patients except in rare overflow situations.
4
In-house attending coverage means that the listed providers are physically onsite and available at the hospital for
night and weekend coverage throughout the shift.
Last updated: 1/30/2017
E4.
Please indicate the number of clinical nurse (RN), advanced registered nurse practitioner
(ARNP) or advanced practice registered nurse (APRN), and Physician Assistant (PA) FTEs5
who work in or directly support your Pediatric and Congenital Cardiology/Cardiothoracic
Surgery program. [If none, please enter 0.]
a.
b.
c.
E4d.
FTE RNs
FTE ARNPs or APRNs
FTE PAs
Staff FTEs
________
________
________
What percentage of RNs working in your CICU or the dedicated Cardiac beds in
the PICU have less than 2 years of experience?
_______% RNs
E4e.
What percentage of RNs working in your CICU or the dedicated Cardiac beds in
the PICU have a BSN?
_______%RNs
E4f.
What percentage of eligible RNs6 working in your CICU or the dedicated Cardiac
beds in the PICU have the CCRN certification for critical care nursing from the
American Association of Critical-Care Nurses (AACN)?
_______% RNs
E5.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program currently
offer an echocardiography laboratory certified by the Intersocietal Commission for the
Accreditation of Echocardiography Laboratories (ICAEL)7 in any of the following areas?
a.
b.
c.
5
Transthoracic echocardiographic testing
Transesophageal echocardiographic testing
Fetal echocardiographic testing
Yes
○
○
○
No
○
○
○
Calculate nurse (RN) clinical FTEs based on total paid hours for the period of review divided by 2080.
6
To be eligible for CCRN certification, nurses must have >1,800 hours of critical care practice within the past 24
months.
7
http://www.intersocietal.org/echo/main/standards.htm
Last updated: 1/30/2017
E6.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program currently
offer the following pediatric cardiovascular services and/or facilities on-site?
Yes
No
a. Inpatient cardiology consultation services
○
○
b. Dedicated pediatric cardiac surgical operating room(s)8
○
○
c. Cardiac intensive care unit (CICU)9 or dedicated beds and staff in a
○
○
NICU or PICU for cardiac patients
d. Remote monitoring capability of cardiac patients in the CICU,
○
○
NICU, or PICU10
11
e. Cardiac diagnostic catheterization laboratory
○
○
f.
Cardiac interventional catheterization laboratory12
○
○
g. Electrophysiology laboratory13
○
○
h. Ventricular assist program14
○
○
i.
Availability of 24/7 cannulation for extracorporeal membrane
○
○
oxygenation (ECMO) for cardiac patients
15
j.
Cardiovascular genetics clinic
○
○
k. Intra-operative transesophageal echocardiographic testing
supervised and interpreted in the operating room by board
○
○
certified/eligible pediatric cardiologists
l.
Pediatric Cardiac Anesthesia services16
○
○
8
These surgical operating rooms are designed and maintained for the surgical care of pediatric and adult congenital cardiac
patients only.
9 A CICU is a specialized unit designed to meet the needs of pediatric cardiac patients, including (a) newborns diagnosed with
critical congenital heart disease, (b) infants and children with congenital or acquired heart disease, (c) infants and children with
arrhythmias, (d) candidates for heart transplantation, and (e) patients with heart disease who require intensive care services
following noncardiac surgery. The CICU is staffed with a multidisciplinary care team, including cardiac intensivists,
cardiothoracic surgeons, and dedicated cardiac nurses. “Dedicated” indicates the beds and staff are used exclusively for cardiac
patients except in rare overflow situations.
10 This is an inpatient unit with specialized equipment allowing physicians, nurses, and other medical staff to monitor each
patient’s status using real-time remote electronic monitoring equipment.
11 This diagnostic facility is where cardiac catheterization is performed to detect the presence of pediatric and congenital heart
disease. Cardiac catheterization is a procedure that involves puncturing an artery or vein and inserting a catheter that can be
guided into the heart and major vessels around the heart. The catheter is moved through the heart with the aid of fluoroscopy (xray machine). This is usually performed to help in providing a diagnosis of heart problems.
12 This laboratory is a diagnostic facility where interventional catheterization is used to treat pediatric and congenital cardiac
conditions. The use of specialized catheters includes balloon catheters that can open up narrowed valves or arteries and catheters
that can be deployed to close extra openings or vessels in the heart.
13 An electrophysiology laboratory is designed to perform diagnostic, therapeutic, and interventional electrophysiology-based
procedures in pediatric and congenital patients such as pacemaker, internal cardiac defibrillator, loop device, and biventricular
device insertions; arrhythmia mapping; catheter ablation for atrial fibrillation; and supraventricular tachycardias.
14 This program should be present in addition to ECMO and is designed to support the placement, monitoring, and support of
patients who require the implantation of a ventricular assist device (VAD) to treat their heart condition. A VAD is a mechanical
blood pump that supports the function of a ventricle.
15 To answer “Yes,” the clinic must have a designated pediatric cardiologist, a pediatric geneticist, a genetic counselor, and a
nursing coordinator.
16
To answer “Yes,” these services should include consultation or care of cardiac patients having non-cardiac surgery, and care
for patients undergoing cardiac catheterization or other diagnostic or therapeutic procedures.
Last updated: 1/30/2017
E7.
Does your hospital provide the following on-site for use with patients in your Pediatric and
Congenital Cardiology/Cardiothoracic Surgery program?
Yes
No
a. Cardiac CT Angiography
○
○
b. Cardiac MRI
○
○
c. Stress echo testing
○
○
d. Quantitative Pulmonary Perfusion Scan
○
○
E8.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program offer the
following procedures? If so, how many were performed during the last calendar year?
[Count only one procedure17 per category completed on a patient within a single day. For
example, if two stents were implanted in the same day, the count would be 1 procedure for
E8c for that patient; if one stent and one balloon valvuloplasty were performed in the same
encounter, the count would be 1 procedure for E8b and 1 for E8c.]
a.
b.
c.
d.
e.
f.
Balloon angioplasty18 without stent implantation (see
code list)
Balloon valvuloplasty (see code list)
Stent implantation (see code list and NCDR-IMPACT
Codes 675 through 850, NCDR-IMPACT sequence
number 5002)
Transcatheter occlusion of cardiac shunts (see code list
and NCDR-IMPACT Codes 240 through 365 coil
occlusions, 370-520 device occlusions)
Transcatheter placement (or attempted placement) of a
stented pulmonary valve (e.g., Melody or other
commercially manufactured valves, may be
investigational) (see code list – note that cases counted in
E8e should NOT be included in E8b)
Stent re-dilation19 (see code list and NCDR-IMPACT
Codes 855 through 1030, NCDR-IMPACT sequence
number 5002)
Yes
No
○
○
○
○
○
○
Procedures
________
________
________
○
○
________
○
○
________
○
○
________
WARNING:
IF E8x1=“Yes” AND E8x2=(0 OR BLANK), DISPLAY:: “E8x: Please check your
responses. You marked that you offer these procedures, but did not report any.”
VALIDATE: IF E8x IS NOT A WHOLE NUMBER, DISPLAY: “E8x (Procedures): Please enter
a whole number (no decimals).”
17
Note that we recommend using the CPT codes for identifying these procedures as they are more specific than the provided
ICD-9 codes. However, if using the ICD-9 codes to identify these procedures, please make sure you only include thoracic
catheter procedures.
18 The same vessel may be counted for a balloon angioplasty (E8a) and a stent re-dilation (E8f), only if the angioplasty occurs
proximally or distally to the stent at a separate lesion.
19 Note that the ICD-9 and CPT codes used for re-dilation are the same as balloon angioplasty without stent implantation. Please
consult with your congenital cardiology and cardiothoracic surgery team to ensure that you do these procedures and that they are
properly accounted for on the survey.
Last updated: 1/30/2017
E9.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program conduct
aortic and pulmonary catheter-based valvuloplasty (see code list) in neonates (< 30 days of
age)?
 Yes – Go to Question E10
 No – Skip to Question E11
E10.
How many aortic and/or pulmonary catheter-based valvuloplasty procedures (see code list)
were performed in neonates (< 30 days of age) in the last calendar year? [If none, please
enter 0.]
________ Procedures
VALIDATE: IF E10 IS NOT A WHOLE NUMBER, DISPLAY: “E10: Please enter a whole
number (no decimals).”
E11.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program offer
transcatheter arrhythmia ablations (see code list)?
 Yes – Go to Question E12
 No – Skip to Question E15
E12.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program offer
transcatheter arrhythmia ablations procedures for the following diagnoses? If so, how
many were performed during the last calendar year? [Count only one procedure per category
completed on a patient within a single day. For example, if one supraventricular tachycardia
(SVT) and atrial tachycardia ablation take place in the same day, the count would be 1 each for
E12a and E12b for this patient.]
Yes No
Procedures
a. Atrial tachycardia (see code list – must have diagnosis and
○
○
procedure codes)20
________
b. Supraventricular tachycardia (SVT) or Wolff-ParkinsonWhite (WPW) syndrome (see code list – must have
○
○
diagnosis and procedure codes)21
________
c. Ventricular tachycardia (see code list – must have diagnosis
○
○
and procedure codes)22
________
WARNING:
IF E12x1=“Yes” AND E12x2=0 OR BLANK), DISPLAY: “E12x: Please check your
responses. You marked that you offer these procedures, but did not report any.”
VALIDATE: IF E12x IS NOT A WHOLE NUMBER, DISPLAY: “E12x (Procedures): Please
enter a whole number (no decimals).”
Please use IMPACT code 10090 and the following descriptions: Myocardium – atrial, Sinus node.
Please use IMPACT code 10090 and the following descriptions: Accessory pathway – concealed, Accessory
pathway - manifest (bidirectional WPW), Accessory pathway - manifest (antegrade only WPW), Accessory pathway
- manifest (unidirectional anterograde decremental pathway - Mahaim), AV node, AV node - fast pathway, AV node
- slow pathway, His bundle, Myocardium - coronary sinus.
22
Please use IMPACT code 10090 and description of Myocardium—ventricular
20
21
Last updated: 1/30/2017
E13.
How many diagnostic electrophysiological procedures (see code list – exclude IMPACT code
10090 and description of Myocardium—ventricular) did your Pediatric and Congenital
Cardiology/Cardiothoracic Surgery program perform in the last calendar year? [If none,
please enter 0.]
________ Number of procedures
E14.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program use the
following methods for transcatheter arrhythmia ablations?
Yes
No
a.
Three-dimensional mapping23
○
○
b.
Cryoablation24
○
○
25
c.
Radiofrequency ablation
○
○
E15.
How many implantation procedures (new or replacement) of permanent transvenous
pacing / cardioversion / defibrillation or event recording devices (see code list) were
performed by an electrophysiologist in the catheterization laboratory or the OR during the
last calendar year? [Count only one procedure per patient day when calculating your total, and
do not count procedures performed by a surgeon since they are separately counted in E38.] [If
none, please enter 0.]
________ Number of procedures
VALIDATE: IF E15 IS NOT A WHOLE NUMBER, DISPLAY: “E15: Please enter a whole
number (no decimals).”
E15.1. Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program offer lead
extraction for pacemaker and automatic implantable cardioverter defibrillator (ICD /
AICD) leads?
 Yes – on site at your hospital
 Yes – off site at a single affiliated hospital
 No
23
This includes the use of three-dimensional imaging systems, such as MRI or ultrasound, to guide ablation probes.
This process uses cooled, thermally conductive gases and fluids circulated through hollow needles (cryoprobes) that are
inserted adjacent to diseased tissue in order to kill the tissue.
25 This procedure involves placing probes that emit radiofrequency energy into the heart using a catheter. The radiofrequency
energy is then used to destroy abnormal electrical activity in the heart tissue.
24
Last updated: 1/30/2017
E16.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program have an
organized adult congenital heart program26 for patients > 18 years of age?
 Yes – on site at your hospital, go to Question E17
 Yes – off site at a single affiliated hospital, go to Question E17 (If at multiple affiliated sites,
must answer no.)
 No – Skip to Question E18
E17.
Does your pediatric and congenital cardiology/cardiothoracic surgery program provide the
following?
Yes
No
a. A formal plan to actively transition patients from the pediatric to adult
○
○
congenital heart program.
b. Joint participation in your program for adults with congenital heart
disease from pediatric and adult cardiologists who focus on congenital
○
○
heart disease.
c. Cardiothoracic surgeons in your program for adults with congenital heart
disease who have specialty expertise in the care of adults with congenital
heart disease (Only check yes if the surgeon/s either have subspecialty
○
○
certification in Congenital Heart Surgery Board or have >10 years of
experience with at least 50% of their practice in congenital heart surgery.).
d. Cardiothoracic interventionalists in your program for adults with
congenital heart disease who have specialty expertise in the care of adults
with congenital heart disease (Only check yes if the interventionalist(s)
○
○
either meet the criteria in Question E2e or have >10 years of experience
with at least 50% of their practice in congenital heart interventions.).
e. Cardiothoracic electrophysiologists in your program for adults with
congenital heart disease who have specialty expertise in the care of adults
with congenital heart disease (Only check yes if the electrophysiologist/s
○
○
either meet the criteria in Question E2f or have >10 years of experience
with at least 25% of their practice in congenital heart electrophysiology.).
f. Specialty care for high risk obstetrics for patients with congenital heart
○
○
disease.
26
This is a multidisciplinary care program designed to addresses the needs of adults with congenital heart disease. Programs
should include cardiothoracic surgeons, cardiac intensivists, cardiac interventionalists, and cardiac electrophysiologists. In
addition, to address the needs of adult patients, the program should have access to specialists in high-risk pregnancy, genetics,
fetal echocardiography, GI and liver disease, pulmonary, and hematology.
Last updated: 1/30/2017
E18.
Please indicate which of the following mechanisms you will use for reporting volume and
outcomes on your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program
for each of the four calendar years listed below. For relevant volume and mortality
questions that follow in this section, the same four calendar years of 2012, 2013, 2014, and
2015 will be used for all data reporting. If your center is using information from the STS
Congenital Heart Surgery Database reports for volume and mortality, the relevant tables
specified in footnotes 27, 28, 29, and 30 must be submitted to receive credit.
STS
Other
CHSD
Source of
report
Data
a. Reporting year 1 (2012)
○
○
b. Reporting year 2 (2013)
○
○
c. Reporting year 3 (2014)
○
○
d. Reporting year 4 (2015)
○
○
E18.1 If you participate in the STS Congenital Heart Surgery Database, please provide the
name of the organization you are listed under in the database.
E18.2 If you will be using data “other” than from the STS Congenital Heart Surgery
Database for reporting (e.g., combination of STS and some other source, another
database used to track cardiothoracic surgeries, or manual review of charts), please
indicate the source below for each reporting year.
E18.3 Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program
participate in the STS Public Reporting On-Line program?31
 Yes
 No
Report based on calendar year 2012 (January 1, 2012 –December 31, 2012); If using the STS Congenital Heart Surgery
Database Report, please submit Tables 6 from the Spring 2013 STS Congenital Heart Surgery Database Feedback Report.
28 Report based on calendar year 2013 (January 1, 2013 –December 31, 2013); If using the STS Congenital Heart Surgery
Database Report, please submit Tables 6 from the Spring 2014 STS Congenital Heart Surgery Database Feedback Report.
29
Report based on calendar year 2014 (January 1, 2014 –December 31, 2014); If using the STS Congenital Heart Surgery
Database Report, please submit Tables 6 from the Spring 2015 STS Congenital Heart Surgery Database Feedback Report.
30 Report based on calendar year 2015 (January 1, 2015 –December 31, 2015); If using the STS Congenital Heart Surgery
Database Report please submit Tables 1, 6, 7, 16, 21, 24, and 27 from the Spring 2016 STS Congenital Heart Surgery Database
Feedback Report.
31
To answer yes, the data for your program must appear on the STS website at: http://www.sts.org/quality-research-patientsafety/sts-public-reporting-online
27
Last updated: 1/30/2017
E19.
What was the total number of adult cardiac surgical operations listed in Table 7 of your
STS Congenital Heart Surgery Database Report for the four reporting years listed in E18?
[For hospitals not reporting STS data, please exclude all secundum ASD’s (see code list for
exclusions), any surgery limited to the mitral or aortic valves, and coronary bypass grafting. Also,
you must count each operative encounter as a single case, even if multiple procedures were
performed during the same operative episode.] [If none, please enter 0.]
________ Number of adult cardiac surgical operations
VALIDATE: IF E19 IS NOT A WHOLE NUMBER, DISPLAY: “E19: Please enter a whole
number (no decimals).”
E20.
Is your adult congenital heart program listed with the Adult Congenital Heart Association
(www.achaheart.org)?
 Yes
 No
E20.1 What was the total number of neonatal cardiac surgical operations listed in Table 7 of your
STS Congenital Heart Surgery Database Report for the four reporting years listed in E18?
[For hospitals not reporting STS data, how many neonatal cardiac surgical operations were
performed on patients <31 days of age (preterm and full term) (see code list) in the four reporting
years listed in E18? Also you must count each operative encounter as a single case, even if
multiple procedures were performed during the same operative episode.] [If none, please enter 0.]
_______ Number of neonatal cardiac operations
VALIDATE: IF E20.1 IS NOT A WHOLE NUMBER, DISPLAY: “E20.1: Please enter a whole
number (no decimals).”
E21.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program have an
on-site heart or heart-lung transplant program recognized by the United Network for
Organ Sharing (UNOS)?
 Yes – Go to Question E22
 No – Skip to Question E26
E22.
How many unique patients (<18 years of age) received heart transplants in your Pediatric
and Congenital Cardiology/Cardiothoracic Surgery program in the four reporting years as
indicated in E18? [If none, please enter 0.]
Unique
Patients
a. Reporting year 1 (2012)
________
b. Reporting year 2 (2013)
________
c. Reporting year 3 (2014)
________
d. Reporting year 4 (2015)
________
VALIDATE: IF E22x IS NOT A WHOLE NUMBER, DISPLAY: “E22x: Please enter a whole
number (no decimals).”
Last updated: 1/30/2017
E22.1 How many of the unique patients in E22 were <1 year of age when they received heart
transplants in your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program
in the four reporting years as indicated in E18? [If none, please enter 0.]
Unique
Patients
a. Reporting year 1 (2012)
________
b. Reporting year 2 (2013)
________
c. Reporting year 3 (2014)
________
d. Reporting year 4 (2015)
________
VALIDATE: IF E22.1x IS NOT A WHOLE NUMBER, DISPLAY: “E22.1x: Please enter a whole
number (no decimals).”
E23.
Please report your program’s Pediatric (<18) 1-year heart transplant patient survival
statistics from Table C15D in your December SRTR report, which includes transplants
performed between 7/1/13 and 12/31/15. [Please refer to tables C15D and C16D of the PDF
version of the December 2016 SRTR report for your center for the requested values. If any
elements of the table from SRTR are blank or listed as N/A, please leave them blank.]
1-year SRTR Measure
Table C15D Value
a. Number of transplants evaluated
______________
b. Estimated probability of surviving at 1 year (unadjusted)
_____________%
c. Expected probability of surviving at 1 year (adjusted)
_____________%
d. Number of observed deaths during the first year after transplant
______________
e. Number of expected deaths during the first year after transplant
______________
f. Estimated hazard ratio
______________
g. 95% credible interval (low value)
______________
h. 95% credible interval (high value)
______________
E24.
Please report your program’s Pediatric (<18) 3-year heart transplant patient survival
statistics from Table C16D in your December SRTR report, which includes transplants
performed between 1/1/11 and 6/30/13. [If any elements of the table from SRTR are blank or
listed as N/A, please leave them blank.]
3-year SRTR Measure
Table C16D Value
______________
a. Number of transplants evaluated
_____________%
b. Estimated probability of surviving at 3 years (unadjusted)
_____________%
c. Expected probability of surviving at 3 years (adjusted)
______________
d. Number of observed deaths during the first 3 years after transplant
______________
e. Number of expected deaths during the first 3 years after transplant
Estimated
hazard
ratio
______________
f.
______________
g. 95% credible interval (low value)
______________
h. 95% credible interval (high value)
Last updated: 1/30/2017
E24.1 Please list the name your hospital reports under to SRTR. Also, please note that we will
verify32 the values reported with the SRTR/UNOS reports for your hospital. If the
SRTR/UNOS values differ from the values reported here, please provide an explanation:
E25.
Please answer the following question about the heart transplants offered by your Pediatric
and Congenital Cardiology/Cardiothoracic Surgery program.
Yes
No
a. Has your pediatric heart transplant program performed cardiac
transplantation in a recipient with high (≥ 10%) panel reactive antibody
○
○
(PRA)?
b. Does your pediatric heart transplant program have a written protocol for
the management of recipients with high (≥ 10%) panel reactive antibody
○
○
(PRA)?
c. Has your pediatric heart transplant program performed an ABO
○
○
incompatible heart transplant?
d. Does your pediatric heart transplant program have a written protocol for
○
○
the management of ABO incompatible recipients?
E26.
How many unique patients in the following age groups were treated with a Berlin heart or
other Ventricular Assist Device (VAD), excluding ECMO (see code list), in the last 4
calendar years (2012-2015)? [If none, please enter 0.]
________ Unique patients (< 1 years of age)
________ Unique patients (>1 and < 3 years of age)
________ Unique patients (≥3 and <10 years of age)
________ Unique patients (≥10 and ≤18 years of age)
________ Unique patients (>18 years of age with congenital heart disease33)
VALIDATE: IF E26x IS NOT A WHOLE NUMBER, DISPLAY: “E26x: Please enter a whole
number (no decimals).”
32
Verification reports are available here:
http://www.srtr.org/csr/current/Centers/TransplantCenters.aspx?organcode=HR. If your reports do not match the values
that are publically available, please provide an explanation.
33
This may include adult patients (over 18) in recognition that many pediatric heart programs continue to treat patients with
certain congenital conditions into adulthood.
Last updated: 1/30/2017
E27.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program offer the
following:
Yes
No
a. Multidisciplinary morbidity and mortality conferences which occurs
at least monthly and includes representatives from cardiology, cardiac
surgery, anesthesia, critical care specialists in intensive care units
○
○
(e.g., NICU, PICU, CICU, or other ICU) who care for heart and heart
surgery patients, and nursing.
b. Multidisciplinary maternal/fetal medicine conference where fetuses
with congenital heart disease are discussed, which occurs at least
○
○
monthly and includes maternal/fetal medicine, cardiology, cardiac
surgery, neonatology, and palliative care specialists, as appropriate.
c. Active home surveillance program34 for infants after single ventricle
○
○
palliation for hypoplastic left heart syndrome
d. A “Neurodevelopmental Follow-Up Program:” a follow-up program
for children with complex congenital heart disease at risk for adverse
○
○
35
neurodevelopmental outcomes
e. Patient planning conference which occurs at least weekly and
includes cardiologists, cardiac surgeons, cardiac anesthesiologists and
○
○
critical care specialists to discuss upcoming surgical cases,
interventional catheterizations and complex case planning.
f.
Support groups for patients and families with congenital heart
○
○
conditions (e.g., Mended Little Hearts)
g. Multidisciplinary management program for complex congenital heart
disease patients who experience long-term change to physical or
○
○
cognitive functioning
E28.
Has your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program currently
engaged in any of the following activities?
Yes
No
a. Developed and implemented a written plan for program review and
○
○
quality improvement
b. Determined appropriate data-based performance metrics for the
○
○
program
c. Regularly tracked patient data (e.g., diagnoses, treatment plans, test
results, emergency department visits, outpatient visits, current treatment
○
○
regimens) and other supporting information to measure progress against
program performance metrics
d. Presented results of your program’s clinical quality performance metrics
○
○
to your clinical staff on a regular basis
e. Participated in one or more quality-of-care or improvement initiatives
○
○
specific to pediatric cardiology/cardiothoracic surgery care
34
This program tracks patients in their home environment, trains parents to assist in care, and establishes protocols for
emergencies.
35 This program tracks children at risk for adverse neurodevelopmental problems following diagnosis and/or treatment of a
pediatric cardiac condition. A “Neurodevelopmental Follow-Up Program” is defined as a follow-up program for children with
complex congenital heart disease at risk for adverse neurodevelopmental outcomes; such programs include cardiac-specific
neurodevelopmental follow-up programs, but may also include non-cardiac specific neurodevelopmental follow-up programs
(e.g. NICU based follow-up programs, developmental pediatrics or psychology based follow-up programs) that routinely see
patients with congenital heart disease who are referred to it. A patient seen by their general pediatrician does NOT meet the
definition of a neurodevelopmental follow-up program.
Last updated: 1/30/2017
E28.1 If “yes” to any part of E28, please describe one quality improvement initiative and
how it improved the quality of your program in the last calendar year. To receive
credit, you must discuss what actions your hospital took as a result of this quality
initiative and the impact it had on your program:
E29.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program currently
participate and contribute data (if applicable) to any of the following?
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Society of Thoracic Surgeons (STS) Congenital Heart Surgery
Database [Credit will only be given if a mortality report (see E18) is
submitted in this survey]
Congenital Heart Surgeons’ Society data center and submit data for at
least one study
National Pediatric Cardiology – Quality Improvement Collaborative
(NPC-QIC)
Congenital Cardiac Anesthesia Society database (participation only)
National Cardiovascular Disease Registry – Improving Pediatric and
Adult Congenital Treatment (NCDR-IMPACT)
Extracorporeal Life Support Organization (ELSO) registry
Pediatric Cardiac Critical Care Consortium (PC4) or Virtual pediatric
ICU System (VPS)
Pediatric Heart Transplant Study (PHTS)
Radiation reduction with either the Reducing Radiation Risk Quality
Initiative of NCDR-IMPACT or the Congenital Cardiac
Catheterization Project (C3PO-QI)
Other externally audited, national quality-improvement initiative
Yes
No
○
○
○
○
○
○
○
○
○
○
○
○
○
○
○
○
○
○
E29.1 If “yes” to E29j, please list:
E30.
36
37
Does your heart or heart surgery program currently participate in one or more the
following types of investigative work? [To answer yes to any of the following, your program
must have had at least one patient enrolled in calendar year 2016, or subjects enrolled prior to
2016 who were in the follow-up phase during 2016.]
Yes
No
a. Single institution retrospective studies
○
○
b. Multi-institutional retrospective studies
○
○
c. Basic science, with extramural funding
○
○
d. Prospective clinical studies or trials36, with industry funding
○
○
e. Prospective clinical studies or trials37, with competitive extramural
○
○
funding
To answer yes, single center or multicenter prospective studies must be listed at ClinicalTrials.gov.
To answer yes, single center or multicenter prospective studies must be listed at ClinicalTrials.gov.
Last updated: 1/30/2017
E31.
Prior to cardiac surgical procedures, does your Pediatric and Congenital
Cardiology/Cardiothoracic Surgery program, engage in the following surgical site infection
prevention procedures?
a.
b.
c.
d.
E32.
Pre-operative bath (bathing with soap and water, chlorhexidinecontaining solution, or wiping with chlorhexidine-impregnated cloth
prior to surgery)
No use of a razor for hair removal (clipper or other non-traumatic
method allowed)
Preparation of skin at surgical site with alcohol containing agent (if no
contraindications)
Screen for and decolonize Staph Aureus
Yes
No
○
○
○
○
○
○
○
○
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program have an
ongoing program to monitor compliance with preoperative antibiotic prophylaxis timing
for cardiothoracic surgeries (see code list)? The ongoing program should capture all
surgeries, or at a minimum capture a monthly sampling of cases based on standard (e.g.,
Joint Commission) sampling recommendations.
 Yes, we monitor for ALL cardiothoracic surgeries – Go to Question E33
 Yes, we have an ongoing monthly program (12 months a year) that monitors timing for a
sample of cases – Go to Question E33
 Yes, we have a program, but monitor less frequently than every month – Go to Question E33
 No – Skip to Question E34
E33.
Of the cases monitored and reviewed, what was your percentage of compliance with the
preoperative antibiotic prophylaxis timing (i.e., incision “cut” time within 60 minutes of
antibiotic infusion, or 120 minutes if vancomycin is used) for cardiothoracic surgeries (see
code list) in the last calendar year? [Calculate as follows: (1) Determine the number of
pediatric cardiothoracic surgeries in which preoperative antibiotic timing was compliant with
guidelines. Exclude cases in which patients are already on scheduled antibiotics that substitute for
prophylaxis. (2) Divide by the number of pediatric cardiothoracic surgeries sampled. (3) Multiply
by 100. (4) Insert the results of steps 1-3 below.]
________ Number of cases compliant
________ Number of cases reviewed
________ Percent compliant
VALIDATE: IF E32=YES AND E33b=(0 OR BLANK), DISPLAY: “E33 (cases reviewed): Please
provide a value greater than 0 or answer No to E32.”
IF E33a/b IS NOT A WHOLE NUMBER, DISPLAY: “E33a/b: Please enter a whole
number (no decimals).”
IF E33a > E33b, DISPLAY: “E33: Please check your responses. Number of cases
compliant cannot be greater than number of cases reviewed.”
AUTOCALC: E23c = [(E23a / E23b) *1000]
Last updated: 1/30/2017
E34.
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program have an
established surveillance system to monitor surgical site infections (SSI) for major
cardiothoracic procedures?
 Yes – Go to Question E34.1
 No – Skip to Question E35
E34.1 If “yes” please provide the definitions used to identify cases, your case-finding
method, and the reporting process (including reporting of surgeon- or servicespecific SSI rates, stratification of SSI rate by procedure type, and frequency of
reports).
E35.
Prior to cardiac surgical procedures, does your Pediatric and Congenital
Cardiology/Cardiothoracic Surgery program, engage in the following surgical safety
procedures?
a.
b.
c.
d.
Conventional pre-procedural “time-out” (including the identification
of patient, operative site, procedure and history of any allergies.)
Pre-procedural briefing (surgeon reviews with all members of the
operating room team the essential elements of the operative plan;
including diagnosis, planned procedure, outline of essentials of
anesthesia and bypass strategies, anticipated or planned implants or
device applications, and anticipated challenges).
Post-procedural debriefing (prior to the patient leaving the operating
suite, the surgeon briefly reviews with all members of the operating
room team the essential elements of the operative plan, identifying key
outcomes).
Hand-off protocol /briefing which includes a checklist (occurs at the
time of transfer (arrival) to the Intensive Care Unit after the end of the
operation, involving the anesthesiologist, surgical team, physician staff
of the Intensive Care Unit and nursing).
Last updated: 1/30/2017
Yes
No
○
○
○
○
○
○
○
○
E35.1 Prior to cardiac catheterization procedures, does your Pediatric and Congenital
Cardiology/Cardiothoracic Surgery program, engage in the following surgical safety
procedures?
a.
b.
c.
E36.
Yes
No
○
○
○
○
○
○
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program use
Clinical Practice Guidelines38 for peri-operative and post-operative care for the following
patient groups/care?
a.
b.
c.
d.
e.
E37.
Conventional pre-procedural “time-out” (including the identification
of patient, operative site, procedure and history of any allergies.)
Pre-procedural briefing (the physician performing the cardiac
catheterization reviews with all members of the catheterization
laboratory team the essential elements of the catheterization plan;
including diagnosis, planned procedure, outline of essentials of
anesthesia and intervention strategies, anticipated or planned implants
or device applications, and anticipated challenges).
Hand-off protocol/briefing which includes a checklist (occurs at the
time of transfer (arrival) to the Intensive Care Unit after the end of the
operation, involving the anesthesiologist, the physician performing the
cardiac catheterization, physician staff of the Intensive Care Unit and
nursing).
Single ventricle/shunt management (e.g. – Norwood, BTS, Glenn,
Fontan)
Two ventricle repairs (e.g. - VSD, TOF, d-TGA/ASO)
Infant feeding (may be part of a. or b.)
Anticoagulation
Sedation and pain management
Yes
No
○
○
○
○
○
○
○
○
○
○
Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program routinely
track and submit EVERY occurrence of the following surgical admission outcomes
parameters to the STS Congenital Heart Database? (DO NOT answer YES unless the data
for all operations are submitted to STS.)
a.
b.
c.
d.
Unplanned reoperation during the same hospital admission as the
primary surgery
Re-exploration for bleeding
Deep sternal wound infection/mediastinitis requiring debridement
Arrhythmia necessitating pacemaker, or permanent pacemaker (STS
Version 3.0 and 3.22)
38
Yes
No
○
○
○
○
○
○
○
○
To answer yes, guidelines should be on a form (paper or electronic), approved for local use, posted in each patients chart to
which they apply, and compliance with the Guidelines should be tracked in the form of a checklist or other mechanism. Hospitals
may include another well-defined and tracked technique to reduce practice variation such as the Standardized Clinical
Assessment and Management Plan or regular discussion and review pf pathways by a multidisciplinary team.
Last updated: 1/30/2017
E37.1. Does your Pediatric and Congenital Cardiology/Cardiothoracic Surgery program
routinely track and submit to IMPACT every unplanned cardiothoracic procedure,
unplanned vascular surgical procedure, unplanned other surgical procedure, or
unplanned subsequent cardiac catheterization due to a catheterization complication
(IMPACT data elements 8160, 8165, 8175, 8180 on the Quarterly IMPACT
Outcome Report)?39
 Yes
 No
SKIP LOGIC: IF E37a=Yes, GO TO E37.2; ELSE SKIP TO E37.4.
E37.2. What was the total number (cumulative incidence) of patients who underwent
Tetralogy of Fallot (TOF) repair surgeries and the total number of these patients
the required an unplanned cardiac reoperation following TOF? [Please refer to and
submit Table 24 (Tetralogy of Fallot Repair, Last 4 Years (Jan 2012 - Dec 2015)) from
the STS Congenital Heart Surgery Database Spring 2016 Feedback Report]. [If none,
please enter 0.]
________Total number of patients who underwent TOF repair surgeries (sum of
incidence of No ventriculotomy” + “Ventriculotomy” + “Ventriculotomy,
Transannular patch” + “RV-PA conduit”)
________Total number of patients that required an Unplanned Cardiac Reoperation
following TOF repair surgeries (sum of Unplanned Cardiac Reoperation” for
“No ventriculotomy” + “Ventriculotomy” + “Ventriculotomy, Transannular
patch” + “RV-PA conduit”)
VALIDATE: IF E37.2x IS NOT A WHOLE NUMBER, DISPLAY: “E37.2x:
Please enter a whole number (no decimals).”
If E37.2b>E37.2a, DISPLAY, “E37.2: Please check your responses.
Number of patients that required an unplanned cardiac reoperation
cannot be greater than the number of patients who underwent TOF
repair.”
E37.3. What was the total number (cumulative incidence) of patients who underwent
Arterial Switch Operations for Transposition of the Great Arteries with intact
ventricular septum (TGA, IVS) and the total number of these patients who were
managed with postoperative Mechanical Circulatory Support following Arterial
Switch Operations for TGA, IVS? [Please refer to and submit Table 27 (Transposition
of the Great Arteries, Last 4 Years (Jan 2012 - Dec 2015)) from the STS Congenital
Heart Surgery Database Spring 2016 Feedback Report]. [If none, please enter 0.]
________Total number of patients who underwent Arterial Switch Operations for
Transposition of the Great Arteries with intact ventricular septum (sum of
TGA, IVS + Switch)
________Total number of patients managed with postoperative Mechanical Circulatory
Support following Transposition of the Great Arteries with intact ventricular
septum (sum of TGA, IVS + Switch)
39
To answer yes, all catheterizations must be submitted to IMPACT.
Last updated: 1/30/2017
VALIDATE: IF E37.3x IS NOT A WHOLE NUMBER, DISPLAY: “E37.3x:
Please enter a whole number (no decimals).”
If E37.3b>E37.3a, DISPLAY, “E37.3: Please check your responses.
Number of patients with postoperative support cannot be greater
than the number of patients who underwent arterial switch
operations.”
SKIP LOGIC: IF E37d=Yes, GO TO E37.4; ELSE SKIP TO E38.
E37.4. If yes to E37d, what was the total number (cumulative incidence) of patients who
underwent VSD repair and total number of these patients that developed
“Arrhythmia req. Permanent Pacemaker” following VSD repair? [Please refer to and
submit Table 21 (Ventricular Septal Defect, Last 4 Years (Jan 2012 - Dec 2015)) from
the STS Congenital Heart Surgery Database Spring 2016 Feedback Report]. [If none,
please enter 0.]
________Total number of patients who underwent VSD repair (sum of incidence of VSD
Type 1 + VSD Type 2 + VSD Type 3 + VSD Type 4)
________Total number of patients that developed “Arrhythmia req. Permanent
Pacemaker” following VSD repair (sum of Arrhythmia req. Permanent
Pacemaker” for VSD Type 1 + VSD Type 2 + VSD Type 3 + VSD Type 4)
VALIDATE: IF E37.4x IS NOT A WHOLE NUMBER, DISPLAY: “E37.4x:
Please enter a whole number (no decimals).”
If E37.4b>E37.4a, DISPLAY, “E37.4: Please check your responses.
Number of patients that developed arrhythmia cannot be greater
than the number of patients who underwent VSD repair.”
E38.
How many cardiac surgeries (see code list) were performed by a pediatric cardiac surgeon
in your pediatric cardiac surgical operating room(s) or catheterization lab during the
calendar years 2012-2015? [If reporting STS data, use the “Operations in Analysis” row from
Table 1 in the STS Congenital Heart Surgery Database Spring 2016 Feedback report for calendar
years 2012-2015. If not reporting STS data, use the ICD-9 or CPT procedure definitions specified
in the footnotes below.] [If none, please enter 0.]
Surgeries
a. Reporting year 1 (2012)
________
b. Reporting year 2 (2013)
________
c. Reporting year 3 (2014)
________
d. Reporting year 4 (2015)
________
VALIDATE: IF E38x IS NOT A WHOLE NUMBER, DISPLAY: “E38x: Please enter a whole
number (no decimals).”
Last updated: 1/30/2017
E39.
How many of the current attending/on-staff congenital heart surgeons in your Pediatric and
Congenital Cardiology/ Cardiothoracic Surgery program performed 75 or more of the
operations listed in question E38 during calendar year 2016?40 [If none, please enter 0.]
________ Surgeons with 75 or more surgical cases
VALIDATE: IF E39x IS NOT A WHOLE NUMBER, DISPLAY: “E39x: Please enter a whole
number (no decimals).”
E40.
How many patients41 meeting the following criteria—single ventricle physiology as verified
by a single ventricle management strategy through 1 year of age; inadequate systemic
outflow tract requiring Norwood42 at Stage 1 or Stage 2; aortic arch obstruction requiring
intervention, and for whom there was intention to treat with an intervention at either your
institution or a transfer center—were managed at your institution as neonates in each of the
following categories for each reporting year? [If reporting based on STS, refer to Table 6 from
the 2012, 2013, 2014 and 2015 reports (Columns: "Overall, N", Rows: "Norwood Procedure" and
“Hybrid Approach Stage 1, Stent placement in arterial duct (PDA) + application of RPA & LPA
bands” and “Hybrid Approach "Stage 1", Application of RPA & LPA bands”). Note that patients
may only be counted once; if a patient undergoes more than one of these procedures, please count
the patient only once using the first procedure.]. [If none, please enter 0.]
Died prior to
Transferred to
surgical
Received
Received Norwood
another center intervention Hybrid Stage 1
Stage 1
a. Reporting year 1
(2012)
________
________
________
________
b. Reporting year 2
(2013)
________
________
________
________
c. Reporting year 3
(2014)
________
________
________
________
d. Reporting year 4
(2015)
________
________
________
________
VALIDATE: IF E40x IS NOT A WHOLE NUMBER, DISPLAY: “E40x: Please enter a whole
number (no decimals).”
SKIP LOGIC: IF SUM (E40a2, E40a3, E40b2, E40b3, E40c2, E40c3, E40d2, E40d3) > 0, GO TO
E40.1; ELSE SKIP TO E42.
40
May include cases from more than one institution, and may average the cases from 2015 and 2016 if an institutional change
occurred during 2016 for any of the attending/on-staff physicians.
41
Note that patients for whom “comfort care” is planned prior to any intervention, surgical or catheter based, should not be
counted; to be removed from the count, the strategy of “comfort care” must be adopted within 72 hours from the time of
admission at your center.
42
Norwood is equivalent to Damus-Kaye-Stansel plus arch reconstruction.
Last updated: 1/30/2017
E40.1 Of the patients you identified in E40 as receiving either a Hybrid Stage 1 or a
Norwood Stage 1 procedure, how many unique patients were alive without a heart
transplant at 1 year of age?43 [If none, please enter 0.]
Hybrid Stage 1
Norwood Stage 1
Patients Alive
Patients Alive
a. Unique patients alive, reporting year
1 (2012)
________
________
b. Unique patients alive, reporting year
2 (2013)
________
________
c. Unique patients alive, reporting year
3 (2014)
________
________
d. Unique patients alive, reporting year
4 (2015)
________
________
VALIDATE: IF E40.1x IS NOT A WHOLE NUMBER, DISPLAY: “E40.1x: Please enter a whole
number (no decimals).”
IF E40.1x1 > E40x3, DISPLAY: “Number of Hybrid patients alive (E40.1x) cannot
be greater the number of patients that received Hybrid surgery (E40x).”
IF E40.1x2 > E40x4, DISPLAY: “Number of Norwood patients alive (E40.1x)
cannot be greater the number of patients that received Norwood surgery (E40x).”
SKIP LOGIC: IF SUM (E40.1a2, E40.1a3, E40.1b2, E40.1b3, E40.1c2, E40.1c3, E40.1d2, E40.1d3)
> 0, GO TO E40.2; ELSE SKIP TO E42.
E40.2 Of the patients you identified in E40.1 who were alive at 1 year of age, how many
had a neurodevelopmental evaluation44 prior to 24 months of age? [If none, please
enter 0.]
________ Unique patients, reporting year 1 (2012)
________ Unique patients, reporting year 2 (2013)
________ Unique patients, reporting year 3 (2014)
________ Unique patients, reporting year 4 (2015)
VALIDATE: IF E40.2x IS NOT A WHOLE NUMBER, DISPLAY: “E40.2x: Please enter a whole
number (no decimals).”
IF E40.2x > (E40.1x1 +E40.1x2), DISPLAY: “Number of patients alive who had an
evaluation (E40.2x) cannot be greater than the number of patients alive (E40.1x).”
43
Note that vital status at one year cannot be assumed, but must be verified by one of the following methods: 1) Your medical
records document a visit/admission to your health system at >= 1 year of age, or an outpatient visit to your health system at > 9
months of age in a patient who has completed a total cavopulmonary anastomosis and was otherwise generally well at the time of
the visit; 2) Your medical records document a visit/admission to a referring health system at >= 1 year of age, or an outpatient
visit a referring health system at > 9 months of age in a patient who has completed a total cavopulmonary anastomosis and was
otherwise generally well at the time of the visit; 3) Direct communication from a health worker at a referring institution in a
written/electronic (letter, e-mail, text message) form documents #2 above; or 4) Direct communication with the family in a
written/ electronic (letter, e-mail, text message) or verbal form documents the vital status at >= 1 year of age.
44
This is a neurodevelopmental evaluation of children following Hybrid Stage 1 or a Norwood Stage 1 surgery at risk for adverse
neurological and developmental outcomes. The evaluation may be done by a cardiac-specific neurodevelopmental follow-up
program or some other neurodevelopmental evaluation program available at your hospital (e.g. NICU based follow-up programs,
developmental pediatrics or psychology based follow-up programs, etc.) as long as they routinely see patients with congenital
heart disease. A patient seen by their general pediatrician for an evaluation does not meet this definition and should be excluded.
Last updated: 1/30/2017
E41.
Question removed from 2017-18 Pediatric Hospital Survey.
E42.
How many unique patient admissions in the four reporting years from Question E38
received surgical procedures in the following Society of Thoracic Surgery & European
Association for Cardio-Thoracic Surgery Congenital Heart Surgery (STAT) Mortality
Categories? Of those patients, how many experienced Operative Mortality? [If reporting
based on STS, refer to Table 1 from the STS Congenital Heart Surgery Database Spring 2016
Feedback Report (Columns for each calendar year 2012-2015: Rows: "Number of Mortalities"
and "Number Eligible" for each STAT Category). For hospitals not participating in STS, count
the volume and deaths according to the STAT definitions.45] [If none, please enter 0.]
a.
b.
c.
d.
e.
Reporting year 1 (2012)
STAT Level 1
STAT Level 2
STAT Level 3
STAT Level 4
STAT Level 5
Unique Patients
________
________
________
________
________
Deaths
________
________
________
________
________
f.
g.
h.
i.
j.
Reporting year 2 (2013)
STAT Level 1
STAT Level 2
STAT Level 3
STAT Level 4
STAT Level 5
Unique Patients
________
________
________
________
________
Deaths
________
________
________
________
________
k.
l.
m.
n.
o.
Reporting year 3 (2014)
STAT Level 1
STAT Level 2
STAT Level 3
STAT Level 4
STAT Level 5
Unique Patients
________
________
________
________
________
Deaths
________
________
________
________
________
p.
q.
r.
s.
t.
Reporting year 4 (2015)
STAT Level 1
STAT Level 2
STAT Level 3
STAT Level 4
STAT Level 5
Unique Patients
________
________
________
________
________
Deaths
________
________
________
________
________
VALIDATE: IF E42x IS NOT A WHOLE NUMBER, DISPLAY: “E42x: Please enter a whole
number (no decimals).”
If E42x2 > E42x1, DISPLAY: “E42x: Please check your responses. The number of
patient deaths cannot be greater than the number of patients.”
45
For information on classifying cardiac surgical procedures into STAT categories, see: Table 1 in J Thoracic and
Cardiovascular Surgery, 2009; 138: 1139-1153 at http://jtcs.ctsnetjournals.org, or use the STAT Table included with this
survey.
Last updated: 1/30/2017
E43.
What was the 4-year combined Risk-Adjusted Operative Mortality for your Pediatric and
Congenital Cardiology and Cardiothoracic Surgery program? [Please refer to Table 16 from
the STS Congenital Heart Surgery Database Spring 2016 Feedback Report. For the combined
reporting years, as indicated in E18, please provide adjusted mortality rate (AMR) from the row
“Neonates + Infants + Children + Adults, All STAT Mortality Categories.” Please leave this
question blank if your program did not receive an adjusted mortality rate in Table 16.]
________ 4-year combined adjusted mortality rate (AMR)
E44.
What was the 4-year combined Risk-Adjusted Operative Mortality for your Pediatric and
Congenital Cardiology and Cardiothoracic Surgery program in each of the following STAT
Mortality Categories? [Please refer to Table 16 from the STS Congenital Heart Surgery
Database Spring 2016 Feedback Report. For the combined reporting years, as indicated in E18,
please provide adjusted mortality rate (AMR) from the section titled “Neonates + Infants +
Children + Adults” for each individual STAT Mortality Category. Please leave this question
blank if your program did not receive adjusted mortality rates in Table 16.]
STAT Level
4-year combined AMR
________
a. STAT Level 1
________
b. STAT Level 2
________
c. STAT Level 3
________
d. STAT Level 4
________
e. STAT Level 5
COMMENTS FOR SECTION E:
If needed, you may provide clarifications to the responses you provided to the questions asked in this
section only. All other comments, suggestions or questions should be sent to
[email protected].
Last updated: 1/30/2017