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About the application:

This apk provides a point-of-care resource for evidence-based and consensus-driven national rules for the health surveillance and care of patients with congenital diaphragmatic hernia (CDH). The rules cover all aspects of care beginning at prenatal diagnosis through to hospital discharge and post-discharge surveillance. The rules are intended for any stakeholder involved in the care of CDH patients, including but not limited to specialty and basic medical care providers, allied health specialists, and families. The apk is organized into distinct sections that correspond to the phase of care. Each phase of care provides suggestions that indicate their level of evidence and the strength of expert consensus. Each suggestion is also accompanied by a brief description of the evidence behind the formulation of the suggestion as well as a list of supportive references. The ultimate goal for the dissemination of the rules is to improve the quality of health care delivery for CDH patients by providing optimal performance benchmarks and removing unwanted variations in care. The apk not only provides access to the rules, but also extra resources that may be beneficial to squads caring for CDH patients. They contain (a) a link to the full, unabridged suggestions that provides more in-depth discussions of supporting evidence; (b) a everyday intensive care rounding checklist designed specifically for CDH patients; (c) a guideline compliance program that allows individual hospital centres to track their adherence to the rules as part of a continuous quality improvement initiative; and (d) two calculators that facilitate the calculation of the observed-expected lung-to-head ratio (o/e LHR) and the oxygenation index (OI). The rules were made by the Canadian CDH Collaborative (CCC). The CCC is a representative group of professionals from across Canada with expertise in the fields of maternal-fetal medicine, pediatric surgery, pediatric anesthesia, neonatal intensive care, neonatal follow-up, pediatric intensive care, and pediatric cardiology. The steering committee of the CCC will modernize the suggestions every three years based on fresh evidence such that the rules are a “living document.” Financial help for the development of the apk was provided by a grant from the Medical Services Staff Association Innovation Fund at Montreal Children’s Hospital.