First and foremost, we are physicians who have dedicated our lives to caring for and caring about patients. We celebrate with families the joys of curing illness; and we are deeply impacted by any death, particularly that of a young child. We lead our respective areas of surgery and pediatrics with the mindset of always doing what is right for children and families. Caring for these children is a privilege. Children and families are always our top priority. Our mission is to provide the best care for all children across North Carolina. We and our colleagues live this mission every day.

Regarding this week’s story from The New York Times (“Doctors Were Alarmed: Would I have my children have surgery here”): We are proud of the medical care provided to all patients at UNC Children’s. They become part of our family, and as providers we wouldn’t hesitate to bring our own loved ones here for treatment. Any negative outcome or death is taken incredibly seriously and we strive to constantly look for ways to improve the care provided.

UNC Children’s provides high-quality, family-centered care to its young patients from all 100 counties in North Carolina and beyond, regardless of a family’s ability to pay. UNC Children’s has been named a “Best Children’s Hospital” for 10 years in a row and is nationally ranked in seven subspecialties.

In 2019, UNC Children’s pediatric cardiac surgery program is saving lives and providing hope to the families of young children. Families from across North Carolina seek us out for cardiac care and for many of North Carolina’s sickest children, UNC Children’s is their last hope, the state’s safety net.

TODAY’S PROGRAM

Decades of continuous quality improvements efforts have led us to strong outcomes today. From July 2018 through May 2019, the Children’s pediatric cardiac surgery program performed 100 surgeries with a 97% survival rate. Likewise, aggregate data from July 2013 – June 2017 illustrate that the program was performing with a 95.4% survival rate , while serving some of the state’s sickest children. However, for our team, and for each family, even a single death is too many, and therefore our continuous quality improvement work is never ending.

TRANSPARENCY FOR FAMILIES

UNC Children’s has published surgery survival data on the UNC Children’s website. We continue to be concerned that it is difficult, if not impossible, to judge a surgical program’s success solely based on the posted data or data that is risk adjusted by the Society for Thoracic Surgeons (STS). We also contend that placing actual data on our own website is in fact, more transparent, and easier for families to find than a website they have most likely never heard of and is difficult to interpret.

CULTURE IMPROVEMENTS

The New York Times’ story on our pediatric cardiac surgery program focused almost entirely on the program from three years ago, during the 2016-2017 time frame. During that period, the program experienced a number of internal cultural challenges related to personality conflicts and difficult group dynamics. Turnover and new leadership have fully addressed those issues, and the current success of the program is unprecedented.

PATIENT PROFILES

We remain focused on quality improvement efforts and enhancing the culture in the pediatric congenital heart surgery program. But our patients and families’ experiences tell the story the best. We invite you to read the detailed stories of a few young patients.

• “UNC Children’s treats 4-year old with rare kidney cancer, spread to her heart” Multidisciplinary team shrinks tumor, performs surgery. Now cancer free.

• “Baby undergoes in utero surgery, followed by heart surgery 22 days later” UNC surgeons repair spinal opening, perform heart and brain procedures.

Today, UNC Children’s pediatric cardiac surgery program is thriving and continuing to save young lives among our most vulnerable population. We are also providing the transparency of outcomes families can rely upon in making their most critical health care decisions.

Melina Kibbe, MD, is the chair of the Department of Surgery and Stephanie Duggins Davis, MD, is the chair of the Department of Pediatrics at the UNC School of Medicine.

Melina Kibbe, MD
Stephanie Davis, MD

 

 

 

 

 

The original opinion piece ran on June 1, 2019 in the News and Observer.