Troubled Children’s Hospital May Resume Heart Surgeries
A North Carolina children’s hospital that stopped performing complex heart surgeries in recent months after high death rates were disclosed may now resume the procedures, according to an advisory board that was examining the hospital’s practices.
The board noted “significant investment and progress” had been made at North Carolina Children’s Hospital while suggesting areas for improvement, including increasing the number of surgeries performed, a factor associated with better outcomes.
The external board made its recommendations in a six-page report released on Tuesday by UNC Health Care, which runs the hospital and is affiliated with the University of North Carolina.
The report was one of several initiatives launched by UNC Health Care in response to a New York Times investigation in May that detailed turmoil at the medical institution in 2016 and 2017, when cardiologists, department leaders and the former head of the children’s hospital expressed concerns about patients faring poorly after heart surgery. Secret audio recordings provided to The Times captured physicians talking openly, some even saying they might not feel comfortable allowing their own children to have surgery there.
Some doctors had tried to get mortality data to help them decide where to refer patients, but the hospital did not have the information to share at the time, even internally. In June, after a yearlong legal battle with The Times, UNC provided data that showed its death rate was especially high among children with the most complex heart conditions — nearly 50 percent.
Dr. Wesley Burks, chief executive of UNC Health Care, said in a statement on Tuesday that the health system had made significant efforts over the years to improve its pediatric heart program, and that it would “make further enhancements because we recognize the importance of caring for very sick children with incredibly complex medical problems.”
The health system did not say when the surgeries would resume.
Last month, state and federal regulators determined the children’s hospital was in compliance with federal rules, but “significantly different than it was during 2016-17,” according to a spokesman for the Centers for Medicare and Medicaid Services. A recent survey by the Joint Commission, which accredits hospitals, also found no current issues with the pediatric heart surgery program.
UNC administrators have denied there were problems affecting patient care during those years, saying only that difficult team dynamics had been resolved by staffing and leadership changes. The chief surgeon from that time has been on leave since earlier this year for “family medical reasons,” according to UNC.
The advisory board did not seem to address conditions at the hospital when doctors voiced concerns several years ago, but noted that “team dynamics and interactions appear to be strong.” Recommendations it made to the hospital’s board of directors included continuing to publicly report mortality data; hiring a second full-time pediatric heart surgeon; and considering a joint venture with another hospital to increase the volume of surgeries.
Concerns about the quality of pediatric heart surgery programs have been disclosed at hospitals across the country, especially at institutions with a smaller number of surgeries. Several programs have been suspended or shut down; other hospitals have merged their programs with larger ones to achieve more consistent results.
The advisory board was composed of three doctors from outside institutions: Nationwide Children’s Hospital in Columbus, Ohio; the University of Michigan School of Medicine; and Children’s Hospital of Pittsburgh.
Two doctors leading UNC’s pediatric heart program previously worked at two of those institutions: Dr. Timothy Hoffman, chief of pediatric cardiology, came to UNC from Nationwide Children’s Hospital. Dr. Mahesh Sharma, chief pediatric cardiac surgeon, joined UNC from Children’s Hospital of Pittsburgh.
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