Practice Patterns in Pediatric Cardiothoracic Presurgical Conferences: A Multicenter Survey Study

Pediatric cardiothoracic surgeries are high-stakes, complex procedures, typically undergoing prior review at multidisciplinary conferences. This study evaluates practice patterns of conferences throughout the United States (US). Surveys were distributed to fellowship program directors or division directors in 124 US pediatric cardiology centers seeking information on conference logistics, fellow roles, quality improvement (QI), and satisfaction. All 47 responding centers (response rate 38%) conduct presurgical conferences, mostly on a weekly basis (92%) lasting 60-120 min (79%). The conferences are solely virtual (19%) or hybrid (81%). High-volume centers (> 300 surgical cases/year) are more likely to hold multiple conferences (13/20 vs 7/27, p < 0.01) and less likely to designate a moderator (11/20 vs 22/26, p = 0.027). Categorical pediatric cardiology fellows at 33 centers present clinical data (97%), echocardiograms (85%), catheterizations (82%), and cross-sectional imaging (39%), typically beginning in their first year. Most centers report that minor (98%) or major changes (51%) are made to patient management at least "sometimes." Responders rate conferences as very important (median 10/10 on a 10-point Likert scale, IQR 9-10), but satisfaction is more modest (median 7/10, IQR 7-9). Only 17% of centers have a formal QI process. Comments from 42 centers reveal positive themes of collaboration (68%) but also concerns about lengthy (30%) or inefficient (36%) discussion. Conclusions: This survey highlights common practices for pediatric cardiothoracic presurgical conferences. Conferences are collaborative and seen as highly impactful. However, satisfaction varies, and QI efforts are infrequent. These findings highlight opportunities for process improvement and standardization.

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Publication Details

Journal
Pediatric Cardiology
Published
2025-08-29
DOI
https://doi.org/10.1007/s00246-025-04008-y
Primary Topic
Cardiac, Anesthesia and Surgical Outcomes
Type
article
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article

Practice Patterns in Pediatric Cardiothoracic Presurgical Conferences: A Multicenter Survey Study

Timothy M. Hoffman, Joshua D. Kurtz, Ryan A. Romans, Rajesh Shenoy et al.
1 links
Pediatric Cardiology
Cardiac, Anesthesia and Surgical Outcomes
article

Practice Patterns in Pediatric Cardiothoracic Presurgical Conferences: A Multicenter Survey Study

Timothy M. Hoffman, Joshua D. Kurtz, Ryan A. Romans, Rajesh Shenoy, Renuka Peterson, Joshua Daily, Michael D. Puchalski, Dilachew A. Adebo, Erica Del Grippo, Michael R. Carr, Mira Trivedi, Susan R. Hupp, Andrew Rodenbarger, Gary Beasley, Brian Reed, Jyoti Patel, Arwa Saidi, Carlen G. Fifer, Thomas Yohannan, Carl Owada, Carolyn M. Wilhelm, Robert D. Tunks, Michael J. Campbell, Mark DeBrunner, Anoop Singh, Louis I. Bezold, Gira Morchi, Poonam Puranik
article en

Abstract

Pediatric cardiothoracic surgeries are high-stakes, complex procedures, typically undergoing prior review at multidisciplinary conferences. This study evaluates practice patterns of conferences throughout the United States (US). Surveys were distributed to fellowship program directors or division directors in 124 US pediatric cardiology centers seeking information on conference logistics, fellow roles, quality improvement (QI), and satisfaction. All 47 responding centers (response rate 38%) conduct presurgical conferences, mostly on a weekly basis (92%) lasting 60-120 min (79%). The conferences are solely virtual (19%) or hybrid (81%). High-volume centers (> 300 surgical cases/year) are more likely to hold multiple conferences (13/20 vs 7/27, p < 0.01) and less likely to designate a moderator (11/20 vs 22/26, p = 0.027). Categorical pediatric cardiology fellows at 33 centers present clinical data (97%), echocardiograms (85%), catheterizations (82%), and cross-sectional imaging (39%), typically beginning in their first year. Most centers report that minor (98%) or major changes (51%) are made to patient management at least "sometimes." Responders rate conferences as very important (median 10/10 on a 10-point Likert scale, IQR 9-10), but satisfaction is more modest (median 7/10, IQR 7-9). Only 17% of centers have a formal QI process. Comments from 42 centers reveal positive themes of collaboration (68%) but also concerns about lengthy (30%) or inefficient (36%) discussion. Conclusions: This survey highlights common practices for pediatric cardiothoracic presurgical conferences. Conferences are collaborative and seen as highly impactful. However, satisfaction varies, and QI efforts are infrequent. These findings highlight opportunities for process improvement and standardization.

Pediatric Cardiology
University of North Carolina at Chapel Hill (US), Children's Hospital of Wisconsin (US), University of Iowa (US), Arkansas Children's Hospital (US), Children's Hospital of Orange County (US), DuPont (United States) (US), Children's Mercy Hospital (US), University of Indianapolis (US), University of Louisville (US), University of Kentucky (US), Johns Hopkins University (US), University of Tennessee Health Science Center (US), Duke University (US), University of Michigan (US), Indianapolis Zoo (US), Riley Hospital for Children (US), University of Florida (US), Johns Hopkins All Children's Hospital (US), Children's Hospital Central California (US), Lurie Children's Hospital (US), Children's Hospital of Pittsburgh (US), Rainbow Babies & Children's Hospital (US), Wolfson Children's Hospital (US), Saint Louis University (US), Indiana University – Purdue University Indianapolis (US), Penn State Milton S. Hershey Medical Center (US), The University of Texas Health Science Center at Houston (US)
Openalex Percentile: Top 65%
Cardiac, Anesthesia and Surgical Outcomes
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