UNC Health Care officials announced Monday they are halting the most complex pediatric heart surgeries following a report that raised serious safety concerns over a number of child deaths at UNC Children's Hospital.
The New York Times reported in May that physicians were growing alarmed at the number of children who were faring poorly after surgery.
Officials from UNC HealthCare said in a statement they plan to create an advisory board of external medical experts and "pause the most complex heart surgeries" until that board and regulatory agencies review the program.
The external advisory board, which is expected to have members from the University of Southern California, the University of Michigan, University of Pittsburgh Medical Center and Nationwide Children’s Hospital, will examine the efficacy of the UNC Children’s Hospital pediatric heart surgery program and make recommendations for improvement. The group will report to the UNC Health Care Board of Directors.
UNC Healthcare officials said they are also developing a new structure to support internal hospital reporting and plan to publicly release Society for Thoracic Surgeons’ (STS) patient outcome data, make a $10 million investment in new technology and bring in new specialists as part of their efforts to "restore confidence" in its pediatric heart program.
“Our pediatric heart program cares for very sick children with incredibly complex medical problems, and our clinical team works tirelessly to help those patients return to normal, healthy and productive lives,” Wesley Burks, M.D., CEO of UNC Health Care said in a statement. “We grieve with families anytime there is a negative outcome and we constantly push to learn from those tragic instances.
UNC Health Care's board also endorsed the creation of a pediatric heart surgery family advisory council to provide a voice for patients, family members and staff directly to hospital leadership.
“The UNCHC Board of Directors and our leadership believe it is important to acknowledge the past time period when our survival rate was below the national average and share data previously used for our internal peer review,” said Charlie Owen, Chairman of UNC Health Care Board in a statement.
He said UNC Health Care and its board of directors continue to have "strong confidence in our extraordinary current pediatric heart surgery team but are taking steps to patients and regulators share that confidence. It plans to resume surgeries only after regulators from the North Carolina Department of Health & Human Services and the Centers for Medicare and Medicaid Services (CMS) and its advisory board believe it's appropriate, he said.
UNC reported previously used its STS data for internal peer review and performance improvement efforts. The data shows over the last four years, the hospital's cardiothoracic surgery program has reported a 3% mortality rate among its neonates, infants and children. In comparison, the neonates in the program had an 8.1% mortality rate in that same time period and its neonates and infants combined saw a 4.6% mortality rate.
UNC Children’s previously posted data on its website showing the number of surgeries performed along with the number of deaths experienced with the belief it offered an easier understanding of survival rates.
"While we are still concerned that the STS data is extremely difficult to evaluate a surgical program’s success based solely upon data that is risk-adjusted by the STS, we are releasing past data to help restore public confidence in the program, and will continue to do so in the future," officials said in a statement.
UNC Health Care is an integrated health care system owned by the state of North Carolina and based in Chapel Hill. UNC Children’s has 150 inpatient beds, a comprehensive outpatient center and nearly 200 physicians who are clinical and research faculty of the UNC School of Medicine. The hospital is nationally ranked by U.S. News and World Report in seven specialties but it is not ranked in pediatric cardiology and heart surgery.
Most recently, Johns Hopkins' All Children's Hospital came under fire for increasing mortality rates among heart surgery patients at the 259-bed hospital following a Tampa Bay Times investigation. Top leaders of that hospital ultimately resigned and Johns Hopkins' board also said it commissioned an external review to examine the heart surgery program.
In 2015, St. Mary's Medical Center in Florida closed it's pediatric heart surgery program after a CNN investigation revealed it had a mortality rate of more than three times the national average. In 2009, Massachusetts General Hospital suspended its pediatric surgery program in the wake of surgical errors.