{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T04:02:16Z","timestamp":1743652936424,"version":"3.40.3"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951125001246_as1\"><jats:title>Background:<\/jats:title><jats:p>The American College of Cardiology has published clinical practice algorithms for common congenital heart lesions, including atrial septal defect, patent ductus arteriosus, valvar pulmonary stenosis, aortic coarctation, and ventricular septal defect. The purpose of this study was to define the current practice patterns in the management of these lesions and describe the impact of departure from these recommendations.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951125001246_as2\"><jats:title>Methods:<\/jats:title><jats:p>This was a retrospective analysis of the most recent 100 outpatient appointments for each lesion at our centre. Electronic medical records were queried to determine whether the scheduling, testing, and follow-up plan for each appointment were consistent with the published algorithms.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951125001246_as3\"><jats:title>Results:<\/jats:title><jats:p>A total of 500 visits were evaluated (150 new visits; 350 follow-up visits); 32% (<jats:italic>n<\/jats:italic> = 162) of encounters did not receive appropriate testing, 37% (<jats:italic>n<\/jats:italic> = 186) departed from recommended follow-up plans, and of the 350 follow-up visits, 45% (<jats:italic>n<\/jats:italic> = 156) departed from scheduling guidelines. Impact of these departures was quantified in reference to over- or under-expenditure of clinical resources. Of the aberrant testing encounters, 60% (<jats:italic>n<\/jats:italic> = 97) saw too few tests. Of the deviant follow-up plans created, 74% (<jats:italic>n<\/jats:italic> = 138) brought patients back to clinic too soon.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951125001246_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>This study explores the deviation between current practice patterns and published clinical care guidelines. There is considerable variation across domain of analysis, diagnosis, and encounter type, resulting in uneven resource utilisation. Standardisation of care in these areas will improve utilisation and can be a starting point for improvement work.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951125001246","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T14:12:51Z","timestamp":1741875171000},"page":"812-817","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Performance against standardization recommendations for outpatient care of common forms of congenital heart disease"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3778-0480","authenticated-orcid":false,"given":"Sara F.","family":"Morehous","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey B.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas J.","family":"Ollberding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Statile","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"S1047951125001246_ref7","doi-asserted-by":"publisher","DOI":"10.1177\/2150135109360915"},{"key":"S1047951125001246_ref4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064400"},{"key":"S1047951125001246_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(97)00196-7"},{"key":"S1047951125001246_ref28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2020-012576"},{"key":"S1047951125001246_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951118000781"},{"key":"S1047951125001246_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01886-7"},{"key":"S1047951125001246_ref26","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2797"},{"key":"S1047951125001246_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/S104795112000013X"},{"key":"S1047951125001246_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ppedcard.2003.01.014"},{"key":"S1047951125001246_ref3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.008396"},{"key":"S1047951125001246_ref15","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12142"},{"key":"S1047951125001246_ref13","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002931"},{"key":"S1047951125001246_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"S1047951125001246_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-018-0325-x"},{"key":"S1047951125001246_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.10.002"},{"volume-title":"Clinical Practice Algorithm for the Follow-up of Unrepaired and Repaired Secundum Atrial Septal Defects","year":"2022","author":"Plummer","key":"S1047951125001246_ref18"},{"volume-title":"Congenital Heart Defects (CHDs)","key":"S1047951125001246_ref1"},{"key":"S1047951125001246_ref9","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.020605"},{"volume-title":"Clinical Practice Algorithm For the Follow-Up of Unrepaired and Repaired Patent Ductus Arteriosus","year":"2022","author":"Hancock","key":"S1047951125001246_ref19"},{"key":"S1047951125001246_ref14","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0086"},{"key":"S1047951125001246_ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078962"},{"volume-title":"Clinical Practice Algorithm For the Follow-Up of Unrepaired and Repaired Ventricular Septal Defects","year":"2023","author":"Birnbaum","key":"S1047951125001246_ref22"},{"key":"S1047951125001246_ref31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017765"},{"key":"S1047951125001246_ref30","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000215"},{"volume-title":"Clinical Practice Algorithm For the Follow-Up of Pulmonary Stenosis Pre- and Post-Intervention","year":"2023","author":"Co-Vu","key":"S1047951125001246_ref20"},{"key":"S1047951125001246_ref12","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021598"},{"key":"S1047951125001246_ref29","doi-asserted-by":"publisher","DOI":"10.1002\/9781119862758.ch2"},{"volume-title":"Clinical Practice Algorithm For the Follow-Up of Repaired Coarctation of the 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Children\u2019s Hospital Medical Center, 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}