How to choose a heart hospital for your child

Making the critical decision about whom to trust with their child’s heart surgery is one of the toughest questions parents could ever face. Last August, I read a great article on CNN.com titled “10 ways to get your child the best heart surgeon.” The tips are good and provide an objective way for parents to work through what could otherwise be an emotional decision.

Tips for parents

I urge you to read the CNN.com article, but I’ll give you a summary of what it suggests for parents.

• Learn all you can about your child’s condition. Go beyond a web or medical library search and talk to experts in your child’s condition. Ask about treatment options, follow-up care, possible complications, how to measure success and what kinds of outcomes to expect. Talk to other parents who have been in your position.
• Consider rankings. Hospital rankings, such as those published by U.S. News & World Report, can help you assess a hospital’s heart center and learn what factors are common among high-performing programs.
• Look for comparative data. High-performing programs readily share their statistics about surgical outcomes, length of stay and neurodevelopmental support options. They are very transparent regarding how their results compare to their peers or national benchmarks. Look for programs that have high volumes, low surgical mortality rates, low infection rates and consistently high scores for patient satisfaction. Ask about results that specifically relate to your child’s condition.
• Look for several highly qualified congenital heart surgeons. Leading heart surgery programs attract leading surgeons and can’t rely on only one of them to cover all cases. Beyond CNN’s thoughts on this, I also share with parents a 2014 recommendation by the American Academy of Pediatrics (AAP) that children who need heart surgery, a transplant and mechanical support be cared for by a certified congenital heart surgeon, a relatively new subspecialty distinction earned through extra training and demonstrated expertise.
• Look for a team with many pediatric heart surgery experts. Backing up CNN’s recognition that “pediatric heart surgery is a team sport,” the same 2014 recommendation by the AAP that I noted before spelled out the ideal physician lineup when kids need heart surgery. The AAP said that “the care of neonates, infants, children, and teenagers with congenital heart disease should occur at specialized centers that include the following: congenital heart surgeons, pediatric cardiologists subspecializing in invasive and noninvasive cardiology, pediatric cardiac anesthesiologists, and pediatric cardiac critical care specialists.”
• Make sure the program is open to second opinions. Second opinions can help confirm that a treatment approach is appropriate and that there aren’t other options to explore — even if treatment has already started. The more information you have, the better the choices you will make to help your child. Most insurance plans cover second opinions and they are worth exploring.
• Understand you may have to travel. The program you decide is best for your child may not be the closest, but it will likely have services to make travel easier for you. I tell my patient families that a hospital geared to help them with travel, lodging and in-town amenities can make a big difference in how comfortable and convenient it is to get the right care.

Additional factors to consider

The CNN list is a great place for parents to start when considering where to take their son or daughter for heart surgery. A few other factors I point out to my patient families include the following:

• Follow-up care makes a difference. Studies show that care immediately following surgery and for years after treatment can boost survival and a child’s successful development. Look for programs that offer home monitoring and neurodevelopmental follow-up after heart surgery.
• Surround your child with caregivers who specialize in kids. From surgeons to nurses to X-ray technicians to the equipment they use — it makes a difference for your child’s physical and emotional well-being when everyone and everything involved in his or her care is specially geared for taking care of kids and their families.
• Look for innovative research and leadership. A heart center that innovates is one that is always looking to improve. These centers are the leaders that attract the best doctors and produce the best results. They offer clinical trials, have strong research divisions and frequently publish research — all of which can add up to more and better treatment options for your child.

Above all, take charge. That is CNN’s last word of advice about choosing a heart surgeon, and I couldn’t agree more. Ask questions, explore options and do all you can to find the best possible care for your child. If you’re curious about how Children’s Wisconsin’s heart surgery program compares, you can get the details on our website.

If you have questions, let us know how we can help!

Peter Frommelt, MD Cardiologist Herma Heart Institute

The Herma Heart Institute at Children’s Wisconsin is one of the nation’s top pediatric heart programs and the largest in the state. We care for patients with congenital heart disease from before birth through adulthood, and we consistently report some of the best surgical outcomes for even the most complex types of heart disease.