Pediatric Cardiac Surgery 

Project Status: Current

Endorsing Performance Measures for Pediatric Cardiac Surgery

Open through August 31st: Call for Nominations, Call for Measures 

The Opportunity

Heart defects are among the most common birth defects and are the leading cause of birth-defect-related deaths1; approximately 35,000 infants (one out of 125) are born with heart defects each year in the U.S. Other children will develop acquired heart disease, including such conditions as arrhythmias, cardiomyopathies, Kawasaki disease, and rheumatic fever. Due to advances in diagnosis and surgical treatment of these children, the mortality rate related to surgery has decreased dramatically from 30 percent in the 1960s and 1970s to around 4 percent today.

However, a retrospective cohort study from 1992 to 1996 revealed that children with Medicaid insurance have a higher risk of dying after congenital heart surgery than those with commercial and some managed care insurance, likely due to care access barriers and differential referral patterns.2 This is significant, as more than 20 million (25 percent) of children in the U.S. rely on Medicaid and SCHIP for health insurance coverage. Survivors—approximately 96 percent of all patients—experience morbidities that seriously impact their quality of life, that of their families, and healthcare consumption and costs borne by society as a whole. Annual charges for inpatient congenital cardiac surgery now exceed $2.2 billion.3

About the Project

In May of 2009 NQF began a project to endorse measures for pediatric cardiac surgery. Performance measurement for healthcare quality reporting and improvement have to date focused largely on the adult population, but there is growing interest and momentum to include pediatric measures in these efforts.

NQF has previously endorsed measures specific to adult cardiac surgery, pediatric heart surgery volume, and pediatric heart surgery mortality. Quality improvement strategies for pediatric cardiac surgery will benefit from specific measures aimed at further reduction of mortality, efficient use of resources, and reduction of morbidities.    


This project seeks to identify and endorse measures for public reporting and quality improvement related to pediatric cardiac surgery processes, structure, and patient outcomes. It will establish national, multi-stakeholder voluntary consensus on current performance standards that are ready for immediate implementation, as well as on recommendations for priority areas for research and measure development.


Candidate measures will be considered for NQF endorsement as national voluntary consensus standards. Agreement will be developed through NQF’s Consensus Development Process (CDP). This project involves the active participation of representatives from across the spectrum of healthcare stakeholders and will be guided by a steering committee.


Funding for this project has been provided by Pediatric Cardiac Surgery Coalition.

Related NQF Work

Contact Information

For more information contact Lisa Hines, BSN, MS, at (202) 783-1300 or


1. Kochanek, K.D., et al. Deaths: Final Data for 2002. National Vital Statistics Reports, volume 53, number 5, October 12, 2004.

2. DeMone JA, Gonzalez PC, Gauvreau K, et al. Risk of Death for Medicaid Recipients Undergoing Congenital Heart Surgery. Pediatric Cardiology. 2006; 24 (2): 97-102.

3. American Heart Association.  Available at:; Last Accessed May 4, 2007.

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