Pediatric Cardiac Critical Care Consortium

Medical Specialty Societies

PC⁴ aims to improve the quality of care to patients with critical pediatric and congenital cardiovascular disease in North America and abroad.

PC4 + ArborMetrix

"There isn’t any question that our partnership with ArborMetrix has been the major driver in getting the collaborative to where we are today. In 2012, we started off with the vision of being a collaborative that could improve the lives of patients and their families touched by congenital heart disease. Through the use of the ArborMetrix platform, we have achieved a significant reduction in cardiac surgical mortality in children since our collaborative was initiated."

Michael Gaies, M.D., M.P.H.

Executive Director, Pediatric Cardiac Critical Care Consortium; Co-Director, Cardiac Networks United

Customer Since


Clinical Registry Use Cases

Quality Improvement Research

Pediatric Cardiac Centers Improve Outcomes for Children With Congenital Heart Disease

The Pediatric Cardiac Critical Care Consortium (PC⁴) aims to improve the quality of care for patients with critical pediatric and congenital cardiovascular disease in North America and abroad. It is a unique collaborative of leaders in pediatric cardiac critical care, cardiac surgery, and cardiology who represent a diverse group of centers caring for these vulnerable patients.

The core pillars of collaborative quality improvement serve as the foundation for PC⁴: purposeful collection of specific clinical data on outcomes and practice, timely performance feedback to clinicians, and continuous improvement based on empirical analysis and collaborative learning. Members include nearly two-thirds of all hospitals caring for pediatric patients with congenital heart disease in the United States.

ArborMetrix’s tailored registry solution for PC⁴ deploys rigorous analytics, grounded in scientific best practices, which results in credible and valid data that builds the physician trust and engagement needed for collaborative quality improvement. PC⁴ provides participating hospitals with:

  • 24/7 access to real-time, reliable, and actionable data to be used for local quality improvement.
  • Risk- and reliability-adjusted comparative analyses on quality metrics selected by the consortium.
  • Innovative and sophisticated informatics platforms that integrate with other registry projects in pediatric cardiac care.
  • Access to unblinded center data to facilitate identification of top performing hospitals and stimulate collaboration between sites to improve patient outcomes.

Learn more about PC⁴ at

Featured Results

PC⁴ and its participating centers have collectively achieved outstanding results and greatly enhanced care for their patients. A few highlights include:

  • Achieved significant reduction in post-surgical mortality in children with congenital heart disease.
  • Published multiple papers leading peer-reviewed journals, such as Critical Care Medicine, Annals of Thoracic Surgery, and the Journal of the American College of Cardiology.
  • Presented multiple abstracts at top international meetings including the American Heart Association Scientific Sessions, American College of Cardiology Scientific Session, and the Society of Critical Care Medicine Congress, and the World Congress of Pediatric Cardiology and Cardiac Surgery.
  • Expanded into a network of networks – called Cardiac Networks United – to inform a more complete understanding and data repository of children with CHD.
  • Received NIH and CTSA program funding.

Featured Research and Publications

  1. Gaies et al. Improvement in Pediatric Cardiac Surgical Outcomes Through Interhospital Collaboration. J Amer Coll Card, in press
  2. Romer AJ et al. Atrioventricular block after congenital heart surgery: Analysis from the Pediatric Cardiac Critical Care Consortium. J Thorac Cardiovasc Surg. 2019.
  3. Tabbutt S et al. A Novel Model Demonstrates Variation in Risk-Adjusted Mortality Across Pediatric Cardiac ICUs After Surgery. Pediatr Crit Care Med. 2019.
  4. Gaies M, Pasquali SK et al. Variation in Adjusted Mortality for Medical Admissions to Pediatric Cardiac Intensive Care Units. Pediatr Crit Care Med. 2019.
  5. Rooney SR et al. Extubation Failure Rates After Pediatric Cardiac Surgery Vary Across Hospitals. Pediatr Crit Care Med. 2019.
  6. Smith AH et al. Variation in Case-Mix Adjusted Unplanned Pediatric Cardiac ICU Readmission Rates. Crit Care Med. 2018.
  7. Alten JA et al. The Epidemiology of Health-Care Associated Infections in Pediatric Cardiac Intensive Care Units. Pediatr Infect Dis J. 2018.
  8. Brunetti MA et al. Characteristics, Risk Factors, and Outcomes of Extracorporeal Membrane Oxygenation Use in Pediatric Cardiac ICUs: A Report From the Pediatric Cardiac Critical Care Consortium Registry. Pediatr Crit Care Med. 2018.
  9. Gaies M et al. Duration of Postoperative Mechanical Ventilation as a Quality Metric for Pediatric Cardiac Surgical Programs. Ann Thorac Surg. 2018.