Editorial: More eyes on pediatric heart programs

The deaths at Johns Hopkins All Children’s Hospital reveal a need for more state oversight.
SCOTT KEELER   |   TimesJohns Hopkins All Children's Hospital, St. Petersburg.
SCOTT KEELER | TimesJohns Hopkins All Children's Hospital, St. Petersburg.
Published March 8

It should not take the deaths of young heart patients to spur action and better oversight of Florida’s cardiac programs. But the rising mortality rate at the Johns Hopkins All Children’s Hospital Pediatric Heart Institute revealed major gaps in how the state monitors quality of care and responds to problems. State lawmakers are right to consider legislation that would tighten oversight and better protect these fragile young patients.

Last year, the Tampa Bay Times revealed the mortality rate at All Children’s Heart Institute tripled between 2015 and 2017 to become the highest of any pediatric heart program in Florida. Parents had no way of knowing, because the only publicly available data was a four-year average surgical mortality rate published by the Society of Thoracic Surgeons. All Children’s refused to release the data for individual years, which would have revealed that the second half of 2016 was the program’s worst six-month period in eight years and that in 2017 it got even worse as nearly 1 in 10 patients died. Patients dying at alarming rates over more than a year begs for both greater transparency and more vigorous oversight.

The state Agency for Health Care Administration, which regulates hospitals, cited All Children’s for not reporting two so-called “adverse incidents” within 15 days, as required by law. That followed earlier Times stories about how All Children’s surgeons left needles in patients twice in 2016. The state’s citations were appropriate but they not adequate to address the cascading problems in St. Petersburg’s venerable children’s hospital. Yet when the Florida chapter of the American Academy of Pediatrics wrote to AHCA recommending a panel of pediatric surgeons review the program, the agency said state law doesn’t allow it. That should be remedied immediately.

Sen. Gayle Harrell, R-Stuart, has filed a bill that would allow teams of pediatric heart doctors to make unannounced visits to struggling programs at the Agency for Health Care Administration’s request to review patient records, inspect facilities and interview frontline and administrative staff. On-site inspections by experts in the field are an important part of ensuring quality care and rectifying problems before they escalate. Lawmakers should consider making such inspections annual to identify potential problems earlier.

Given the recent tragedies at All Children’s, where kids died following common heart surgeries, lawmakers should have increase oversight and transparency at Florida’s pediatric heart programs. No parent of a sick child should find out after the fact that a hospital they trusted made mistakes and failed to report them, and that the state failed to intervene. That’s what happened at All Children’s, and that’s what stronger oversight authority can prevent from happening again.

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