Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Cardiovascular Surgery, Children's Minnesota, Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, Minnesota.
Ann Thorac Surg. 2023 Nov;116(5):871-907. doi: 10.1016/j.athoracsur.2023.08.016. Epub 2023 Sep 29.
Care and outcomes for the more than 40,000 patients undergoing pediatric and congenital heart surgery in the United States annually are known to vary widely. While consensus recommendations have been published across numerous fields as one mechanism to promote a high level of care delivery across centers, it has been more than two decades since the last pediatric heart surgery recommendations were published in the United States. More recent guidance is lacking, and collaborative efforts involving the many disciplines engaged in caring for these children have not been undertaken to date. The present initiative brings together professional societies spanning numerous care domains and congenital cardiac surgeons, pediatric cardiologists, nursing, and other healthcare professionals from diverse programs around the country to develop consensus recommendations for United States centers. The focus of this initial work is on pediatric heart surgery, and it is recommended that future efforts focus in detail on the adult congenital population. We describe the background, rationale, and methodology related to this collaborative effort, and recommendations put forth for Essential Care Centers (essential services necessary for any program), and Comprehensive Care Centers (services to optimize comprehensive and high-complexity care), encompassing structure, process, and outcome metrics across 14 domains.
每年在美国接受儿科和先天性心脏病手术的超过 40000 名患者的护理和结果众所周知存在很大差异。虽然已经在许多领域发布了共识建议，作为在各中心推广高水平护理服务的一种机制，但自美国上一次发布儿科心脏手术建议以来，已经过去了二十多年。最近缺乏指导，并且迄今尚未开展涉及照顾这些儿童的众多学科的合作努力。本倡议汇集了涵盖众多护理领域的专业协会以及先天性心脏外科医生、儿科心脏病专家、护理和来自全国各地的不同项目的其他医疗保健专业人员，为美国中心制定共识建议。这项初步工作的重点是儿科心脏手术，建议未来的工作详细关注成人先天性人群。我们描述了这一协作努力的背景、基本原理和方法，并提出了建议，包括必要的护理中心（任何项目都需要的基本服务）和综合护理中心（优化全面和高复杂度护理的服务），涵盖了 14 个领域的结构、过程和结果指标。
