This research group developed a novel risk–adjustment model to measure quality of care in cardiac intensive care units (CICUs) following pediatric cardiac surgery.

The team performed a comparative analysis of hospitals in the Pediatric Cardiac Critical Care Consortium (PC4) using this method to measure mortality rates attributable to the quality of CICU care. They analyzed 8,543 CICU admissions from 23 hospitals, adjusting for severity of illness variables at the time of care transfer to the CICU.

Among the participating hospitals, four were statistical outliers — two with better than expected mortality; two with worse than expected mortality. This is the first report demonstrating variation in CICU quality across hospitals; the team found no apparent association between CICU volume and case mix adjusted mortality.

These findings have important implications for hospitals performing pediatric cardiac surgery. Understanding quality across the different components of surgical care – intraoperative (surgery and anesthesia) vs. postoperative (CICU) care – may highlight opportunities to improve outcomes for these children.

The findings were presented at the 20th Annual Update on Pediatric and Congenital Cardiovascular Disease.