Table 2

Definitions (adequate vs inadequate) of outcome metrics

Outcome metricsDefinition of adequateDefinition of inadequate
Documentation of radiation surrogatesWhen all three indicators (FT, air kerma and DAP) were recorded.When only one or two indicators were recorded.
Operator techniqueWhen radiation protocols as low as reasonably achievable (ALARA), along with appropriate use of cine imaging and magnification were used.High fixed frame rate imaging along with excessive cine imaging or magnification was used.
Staff radiation protectionWhen lead aprons, thyroid collars and correctly positioned dosimeter badges were all used. Quarterly check of dosimetry badges.When appropriate radiation protective gear was not used or dosimetry badges not regularly checked.
Self-interest and knowledge of CCL staffWhen the staff demonstrated understanding of case details such as diagnosis, the purpose of the catheterisation, and possible adverse events and their management.
Additionally ability to perform accurate haemodynamic calculations.
Lack of knowledge of case diagnosis, purpose of catheterisation and possible adverse event.
Catheterisation report documentationDocumentation was considered ideal when all the variables required by the C3PO-QI database were recorded. Documentation was considered adequate if it did not meet the criteria for ideal or inadequate.In the absence of any of variables (diagnosis, access site, size of devices, stent/balloon details and adverse event details), the documentation was deemed inadequate.
  • CCL, cardiac catheterisation laboratory; C3PO-QI, Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement; DAP, dose area product; FT, fluoroscopy time.