Steps include releasing data on patient outcomes, forming an external advisory board, pausing some complex surgeries temporarily, investing in program enhancements and more.
Media contact: Phil Bridges, 919-457-6347, phil.bridges@unchealth.unc.edu
CHAPEL HILL, N.C. – June 17, 2019 — UNC Health Care announces a number of initiatives to restore confidence in its pediatric heart surgery program. Those steps include releasing Society for Thoracic Surgeons’ (STS) data on patient outcomes, investing in new technology and other enhancements, bringing in new medical specialists, creating an advisory board of external medical experts, pausing the most complex cases until that board reviews the program and makes recommendations, developing a new structure to support internal hospital reporting, and more.
UNC Health Care is committed to providing the highest quality care to all patients in its pediatric heart surgery program.
“Our pediatric heart program cares for very sick children with incredibly complex medical problems, and our clinical team works tirelessly to help those patients return to normal, healthy and productive lives,” said Dr. Wesley Burks, CEO of UNC Health Care. “We grieve with families anytime there is a negative outcome, and we constantly push to learn from those tragic instances.
“I want to acknowledge in the sincerest way possible, that for our team and me personally, the death of any child is one too many,” Burks continued. “These steps are part of a comprehensive effort to ensure UNC Health Care’s mission to serve all North Carolinians with the highest quality care.”
“The UNCHC Board of Directors and our leadership believe it is important to acknowledge the past time period when our survival rate was below the national average and share data previously used for our internal peer review,” said Charlie Owen, Chair of UNC Health Care Board.
A summary of efforts endorsed by the UNC HC Board of Directors includes:
- Releasing Society for Thoracic Surgeons’ (STS) data on patient outcomes publicly;
- Creating an External Advisory Board of medical experts to examine the efficacy of the UNC Children’s Hospital pediatric heart surgery program and make recommendations for improvement. Members are expected to come from the University of Southern California, the University of Michigan, University of Pittsburgh Medical Center and Nationwide Children’s Hospital. This group will report to the UNC Health Care Board of Directors;
- Temporarily pausing the most complex pediatric congenital heart surgeries until the External Advisory Board fully reviews the program and regulatory agencies (DHHS / CMS) complete their review and issue a report;
- Creating a new pediatric heart surgery Family Advisory Council to improve the patient experience by providing a voice for patients, family members and staff directly to hospital leadership;
- Recruiting additional physicians and care providers for the pediatric heart surgery team;
- Making incremental investments in technology and other enhancements in the program to total $10 million over the two prior years and next year;
- Developing a new structure / system to support our Hospital Quality and Safety reporting efforts with escalation processes to keep senior leadership and the Board of Directors informed;
Temporary Procedure Pause
UNC Children’s will temporarily pause performing some of the more complex surgeries aimed at repairing congenital heart defects in children. “While UNC Health Care and its Board of Directors have strong confidence in our extraordinary current pediatric heart surgery team, we believe it is vitally important that both current and future patients, our medical colleagues, key regulators, and the public share this confidence,” Owen explained.
“Therefore, we will await the final report of the N.C. Department of Health & Human Services and the Centers for Medicare and Medicaid Services (CMS). We also will convene an External Advisory Board answerable directly to the Board in conducting its own evaluation of the pediatric heart surgery program. We will resume performance of these surgeries only after both regulators and the esteemed physicians on the Advisory Board agree it is appropriate,” Burks added.
STS Data Now Public
UNC Hospitals has shared mortality data from its pediatric heart surgery program from the Society of Thoracic Surgeons (STS) dating back to 2005 when there were just 34 participants. The latest analysis of data by STS (posted on the UNC Children’s website), covers a four-year period dating from January 2015 to December 2018 and includes 119 participants.
All hospitals that contribute to the STS database have the option to make their data publicly available on the STS website, or to maintain confidentiality of their individual datasets. UNC previously used its STS data for internal peer review and performance improvement efforts. Today’s announcement represents a change in that approach.
UNC Children’s previously posted data on its website showing the number of surgeries performed along with the number of deaths experienced with the belief it offered an easier understanding of survival rates. While we are still concerned that the STS data is extremely difficult to evaluate a surgical program’s success based solely upon data that is risk-adjusted by the STS, we are releasing past data to help restore public confidence in the program, and will continue to do so in the future.
Previously, there were past periods in which for the most complex cases, survival rates were lower than the national average, while survival rates for less complex cases were higher than the national average. Through personnel changes and other improvements program results during the past year have been very strong. Over the past 11 months, July 2018 through May 2019, the program performed 100 surgeries with a 97% survival rate.
Additionally, UNC Children’s has requested that the Society for Thoracic Surgeons publicly report UNC Children’s data on the STS website with the Society’s next public release. In the meantime, UNC has published previous STS data on the Children’s website at https://www.uncchildrens.org/uncmc/unc-childrens/care-treatment/heart/outcomes.
Program & Quality Improvements
UNC Health Care will develop a new structure / system to support its hospital Quality and Safety reporting efforts with escalation processes built in to ensure senior leadership and the members of the UNC HC Board of Directors are kept informed.
In 2018, UNC opened a new pediatric catheterization laboratory and upgraded imaging equipment for 3-D echocardiography. In 2018-2019, the program team developed improved cardiac education for team providers, created enhanced PICU and NICU fellow education, and updated pathways and protocols.
This summer, a dedicated Cardiac Intensive Care unit will open at UNC Children’s Hospital. In addition, a new structure for internal reporting has been developed with roll-out planned over the next several months. The newly formed External Advisory Board, comprised of physicians from other respected health institutions, will help the organization review its pediatric heart program.
UNC Health Care remains deeply committed to providing excellent and safe care to all patients, including those in the pediatric heart surgery program. We are confident in our current team and believe the actions we have taken, moving forward, will serve to advance ours into a top program caring for the children of North Carolina.
Personnel and Program Changes
The pediatric congenital heart surgery program has undergone significant strategic personnel changes since 2016. A number of important key hires have been made. In July 2016, Dr. Melina Kibbe joined UNC Health Care as Chair of Surgery. Dr. Kibbe hired Dr. John Ikonomidis to serve as Chief of the Division of Cardiothoracic Surgery. This was followed by the addition of Dr. Mahesh Sharma as new Section Chief of Congenital Cardiac Surgery in June 2018. New Chair of Pediatrics, Dr. Stephanie Davis, joined UNC Health Care one month later in July 2018. Three new pediatric cardiologists and two new pediatric cardiac intensivists have been hired for the program. They will begin work this summer.
About UNC Health Care
UNC Health Care is an integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. For more information, please visit www.unchealthcare.org.
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