The Power of Learning Networks: The story of Pediatric Acute Care Cardiology Collaborative (PAC3) September 14th 2021 Lecture

Although congenital heart disease is the most common birth defect, there is heterogeneity of cardiac lesions making any specific type a rare disease. Aggregating clinical data from many pediatric heart centers into registries, and merging registry data across the field of CHD, holds the promise of producing sufficiently large data sets to accelerate knowledge discovery. Coupling this data with a pediatric learning health system, purposefully designed to execute quality improvement across these multiple centers and to implement evidence at the point of care, can exponentially accelerate the capacity to act on this new knowledge. In this talk we will describe the development of PAC3 , the Pediatric Acute Care Cardiology Collaborative, which we founded in 2015, its place alongside other pediatric cardiology registries (Cardiac Networks United), and the power of Learning Networks in general to hasten the translation of discovery to improvements in care and outcomes.

Alaina Kipps

Alaina Kipps, MD, MS grew up in Santa Cruz, California and completed her medical degree at Harvard Medical School in 2003. After general pediatrics residency at Stanford, she completed pediatric cardiology fellowship at Boston Children’s Hospital then returned west to practice at University of California, San Francisco until 2012. She was recruited back to Stanford in 2012 to become the medical director for acute care cardiology. In 2014 she co-founded the PAC³ network with Nicolas Madsen and co-directs this today. Her academic focus is in clinical effectiveness and quality improvement science, and she recently completed the SMCI Advanced course in improvement science. Her other significant interest is in teaching; she co-directs the pediatric residency cardiology rotation at Stanford.

Nicolas L. Madsen

Nicolas L. Madsen, MD, MPH joined the Heart Institute at Cincinnati Children’s Hospital in July 2012. He attended the University of California at Davis, where he graduated with honors. He earned his medical degree with honors at the University of Washington in 2005. Dr. Madsen completed his residency in general pediatrics and his fellowship in pediatric cardiology at Seattle Children’s Hospital in Seattle, Washington. In addition, Dr. Madsen earned a Master of Public Health from the University of Washington in2011. Dr. Madsen’s clinical focus is in acute care cardiology and long-term outcomes for children born with congenital heart disease. These interests motivated Dr. Madsen to co-develop PAC³ in 2014. His hope is that PAC³ will aid in the care of children hospitalized with cardiac conditions in regard to reducing complications, shortening hospital length of stay, decreasing the frequency of readmissions, and improving the patient and family experience.

John Shook learned about lean management while working for Toyota for 11 years in Japan and the U.S., helping it transfer production, engineering, and management systems from Japan to NUMMI and other operations around the world. While at Toyota's headquarters, he became the company's first American kacho (manager) in Japan. In the U.S., Shook joined Toyota’s North American engineering, research and development center in Ann Arbor, Michigan as general manager of administration and planning. His last position with Toyota was as senior American manager with the Toyota Supplier Support Center in Lexington, Kentucky, assisting North American companies adopt the Toyota Production System. Shook co-authored Learning to See, the book that introduced the world to value-stream mapping. He also co-authored Kaizen Express, a bi-lingual manual of the essential concepts and tools of the Toyota Production System. With Managing to Learn, Shook revealed the deeper workings of the A3 management process that is at the heart of Toyota’s management and leadership.
Shook is an industrial anthropologist with a master’s degree from the University of Hawaii, a bachelor’s degree from the University of Tennessee, and is a graduate of the Japan-America Institute of Management Science. At the University of Michigan, he was director of the Japan Technological Management Program and faculty member of the Department of Industrial and Operations Engineering.
Shook is the author of numerous articles, including "How to Change a Culture: Lessons from NUMMI"; Sloan Management Review, January 2010, which won Sloan’s Richard Beckhard Memorial Prize for outstanding article in the field of organizational development.

The Stanford Medicine Center for Improvement benefits from the diversity of its members and the richness of the experiences that they bring. Although the program continues to evolve from when it first launched in October 2019, we continue to reach out to improvers across Stanford Medicine in the School of Medicine, Stanford Health Care, Stanford Children’s Health, Stanford ValleyCare, UHA and PCHA. We welcome everyone from every discipline and recognize that we are stronger together as we value the contributions of every member of our teams.

Dr. Paul Maggio is Vice Chair of Surgery for Clinical Affairs, Associate Chief Medical Officer of Operational Effectiveness, and Associate Director of the Adult Intensive Care Unit. He trained in General Surgery at Brown University and obtained advanced training in Adult Surgical Critical Care and Trauma at the University of Michigan. He holds a Masters of Business Administration from the University of Michigan and is triple board certified in General Surgery, Critical Care, and Medical Informatics. In addition to being a clinician and surgeon, Dr. Maggio participates in the National Committee on Healthcare Engineering for the American College of Surgeons, and his research interests are focused on the delivery of high-value care.

Dr. Maggio received the SHC Board of Hospital Director’s Denise O’Leary Award for Clinical Excellence in 2013

Micah Duchesne joined Stanford Medicine in 2020 as a Principal Consultant project managing the deployment and operations of the Hospital Incident Command System (HICS) for COVID-19. He is now the Administrative Director of Performance Improvement at Stanford Health Care where he leads annual operations planning, improvement consulting, and capability development. Micah is also a Fellow at the Stanford Medicine Center for Improvement.

Before joining Stanford, Micah was an independent consultant for his company Silicon Valley Strategy Group, which partnered with Novartis and the Perelman School of Medicine at the University of Pennsylvania to commercialize cellular therapies. He led a team of clinicians from Europe, Japan, and Australia in designing a global logistics model and quality management system for Kymriah, the world's first approved CAR-T therapy, and helped create an international advisory board aimed at improving global capacity.

Prior to independent consulting, Micah was the Director of Performance Improvement at Kaiser's Santa Clara Medical Center, and he previously held improvement roles of increasing complexity within other health systems. Micah has both a Bachelor of Science in Accounting and Master of Health Services Administration from Mississippi College. He also holds certifications as a Lean Six Sigma Master Black Belt and Project Management Professional.

As a professional, Micah enjoys organizing complex stakeholder ecosystems, clarifying ambiguous goals, aligning visions, and driving high-stakes change. As a human, Micah just enjoys breaking a sweat. While he's not at work, he's at his very own gym in San Jose, CrossFit Moxie. You can find him there coaching olympic weightlifting or working out with his wife. He has a daughter in elementary school and two gym dogs.