Introduction to PAC³ QI

Introduction to PAC³ Quality Improvement

PAC³ uses improvement science to enhance care, utilizing the Institute for Healthcare Improvement’s (IHI) Breakthrough Series (BTS) model. This approach integrates rapid learning and data-driven decision-making.

Quality improvement efforts result in better patient outcomes, increased efficiency, enhanced patient safety, higher patient satisfaction, improved staff satisfaction and engagement, and opportunities for innovation.

PAC³ focuses on three distinct pathways for quality improvement:

Path 1 focuses on center-based quality improvement efforts, supported by PAC³ through QI Education and multiple shared learning opportunities throughout the year. Path 1 projects can evolve into a Path 2 or Path 3 project.
Path 2 brings together multi-disciplinary acute care cardiology clinical teams from across the nation to engage in impactful quality improvement projects, fostering collaboration and shared expertise. Path 2 projects can have the opportunity to become a Path 3 project.
Path 3 work involves implementing network-wide quality improvement projects based on evidence-based practices, ensuring consistent and effective care across the entire network.

PAC³ exists to support quality improvement work in these three pathways in support for improving acute cardiology care for all pediatric patients.

Path 1

QI Education Course

The QI Education Course offers a didactic learning experience centered around a local QI project. This annual course runs for 6 months, typically from summer to winter. Traditionally, four PAC3 members are selected for this course. Prospective participants must apply with a well-developed project idea and have an identified sponsor or local expert to support the project, addressing any local barriers to completion. Each class is held monthly and are taught by guest instructors and QI experts from the PAC3 community. Participants present updates on their project during each class and are provided live coaching as a crucial component of the program. At the end of the course, participants will have acquired foundational knowledge in quality improvement and, hopefully, have developed a meaningful QI project. Participants are highly encouraged to present their work at the Spring In-Person PAC3 Conference. You can find more information on the QI Education Course here.

Quality-focused presentations
- PAC³ offers a variety of quality-focused presentations each year, including but not limited to fireside chats with QI legends, Panels on QI publication/promotion, webinars on QI concepts (i.e. overcoming barriers, leading change, etc.).
PAC³ Conference Abstracts
- All PAC³ centers are encouraged to submit QI work to our yearly abstract session for the Spring conference. All abstracts are reviewed by the organizing team, which includes a member of the QI committee from PAC3, the QI committee from PC4, and SRC committee from PAC³. You can see sample posters from our Spring 2024 Conference here.

Path 2

Multi-Center Improvement Work

Path 2 facilitates multi-center quality improvement projects between collaborating centers in good standing in the Pediatric Acute Care Cardiology Collaborative. Interested individuals apply for Path 2 approval from the Quality Improvement Committee and invite 3-5 centers to participate in shared QI testing and learning. Before approval, projects must establish a SMART aim, a key driver diagram, operational definitions measures and baseline data. PAC³ anticipates supporting 2 Path 2 projects annually. Participating centers are expected to establish a QI champion, participate in monthly team meetings and provide a quarterly report of progress. Completed work is recommended for submission for presentation at national meetings.

Path 3

Network-Wide Improvement Work

Path 3 supports the mission of PAC³ by leveraging the wider network and registry data to produce large-scale improvement. Path 3 project cycles usually last between 18-24 months, with 12 months for the initial cohort and 6 additional months to spread or sustain the work. An additional 3-6 months should be anticipated for creation of a Spread Package and publication.
Path 3 projects require significant planning and project management time from PAC³ administration, quality improvement specialists, the data team and project leaders. These projects also require the involvement of an initial project lead/champion who is responsible for working with the PAC³ staff to develop timeline, recruit centers, lead monthly webinars, provide updates/presentations at conferences/meetings, and ultimately write up the results.
The initial phase of Path 3 projects typically involves 6-9 centers, with an evaluation for broader implementation at 12 months. Path 3 projects are best identified through a rigorous process that includes examining outliers or best practices from the PAC³ registry or survey data, as well as reviewing successful Path 1 or Path 2 projects.
When evaluating Path 3 project ideas, PAC³ considers the project’s overall aims, timeline, required organizational support and resources, interest and participation from network centers, and the identification of an Executive Committee or QI leadership champion. This work is critical before recruiting centers to participate.
The initial cohort of centers is selected based on their ability to commit to the project and sustain data collection efforts. Introduction and onboarding webinars help manage data burden and clarify the scope of interventions for centers considering joining. Monthly webinars provide QI education, data updates and a platform for teams to discuss any issues.
The baseline data collection phase can take 1-3 months, depending on the project. This phase allows for the development of the data collection process, defining of measures and creation of possible interventions.
The intervention phase lasts 6-9 months supporting for the designing and testing of local adaptation of interventions.
Three historical examples: Chest Tube Project, Data Entry Project, Hearts to Home Discharge Project