Key result
~71% of surgeons in joint pediatric cardiac programs perceive better outcomes but still prefer regionalization.
Why the study?
Joint programmes may improve congenital cardiac surgery outcomes while avoiding resource and accessibility challenges from regionalisation, but their characteristics and success factors are not well described.
Cross-Sectional (n=34)
While most participants in joint paediatric cardiac surgery programmes believe they produce better outcomes than separate programmes, few consider them the optimal model for care delivery.
Answers are grounded in this paper and cite their sources.
Joint programmes may improve perceived outcomes in congenital cardiac surgery; leaves open whether they represent the optimal care model.
OBJECTIVE: Joint programmes are an alternative model that may aid in improving congenital cardiac surgery outcomes while avoiding the potential resource and accessibility challenges that could result from regionalisation. This study aims to characterise current joint programmes, identify factors that are associated with joint programme success and failure, and gauge attitudes within the profession regarding joint programmes as an alternative. METHODS: A multiple choice survey with 23 standard questions for all programmes and additional 42 additional questions for each participant hospital in a joint programme was addressed to paediatric cardiac surgeons in the United States of America. Questions were designed to qualitatively and quantitatively characterise congenital cardiac surgery joint programmes. RESULTS: Of the 34 unique congenital cardiac surgery programmes identified in this survey, 14 have participated in a joint programme and 50% of those joint programmes existed for more than 10 years. Most joint programmes (86%) participate or participated in a model where the hospital participants are engaged in a "mother-daughter" relationship in both perception and case volume distribution. In three out of four defunct joint programmes, there were case complexity limitations placed on partner institutions, but the now independent partner institutions operate with no limitation on complexity. Most (71%) hospital participants in a joint programme felt that the joint programme produced better outcomes than two separate programmes; however, among those who participate or have participated in a joint programme, only 18% felt that joint programmes were the optimal model for delivery of congenital cardiac surgical care.
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Toomey et al. (2022) conducted a cross-sectional in Paediatric cardiac surgery programmes (n=34). Joint programmes in paediatric cardiac surgery vs. Independent programmes was evaluated on Characteristics and perceptions of joint programmes. Among surveyed US paediatric cardiac surgeons, 71% of those in joint programmes felt they produced better outcomes than separate programmes, though 76% still viewed regionalisation as the optimal model.
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