Golden Hour in Congenital Heart Disease
Golden hour involves delayed cord clamping, skin-to-skin contact between mother and newborn, early initiation of breastfeeding, and mother-newborn togetherness, all within 1 hour of birth. Newborns with CHD may be deprived of this practice due to challenges related to patient acuity and a general lack of awareness regarding these practices and their benefits. We are conducting a quality improvement project to increase the implementation of Golden Hour in newborns with CHD by promoting innovation in service delivery, educating staff on golden hour importance and safety, and empowering caregivers through education during the peripartum period.

Developmental Care for Patients and Families with Congenital Heart Disease
Children with congenital heart disease are at risk for poor neurodevelopmental outcomes. Family-centered developmental care practices may promote healthy brain development in neonates with CHD. Developmental care practices include kangaroo care, breastfeeding, oral immune therapy, oral stimulation, mitigating noxious environmental stimuli, and facilitating pain management. Through our quality improvement project, we hope to increase the frequency of developmental care implementation in our intensive care unit and inpatient wards, as well as empower caregivers to implement these practices during and after hospital discharge.

Comprehensive Cardiology Follow-up Program
We are working to create a Comprehensive Cardiac Follow-up Program (CCFP) for children with CHD to facilitate developmental surveillance, screening, evaluation, and re-evaluation throughout childhood. The goal of this program is to enhance academic, behavioral, psychosocial, and adaptive functioning. For children with low-risk CHD, we will facilitate developmental surveillance in the community by building stronger partnerships with community general practitioners and pediatricians in order to assist care standardization and education. Children identified as high-risk will be invited to the CCFP clinic for sequential developmental and medical evaluation, and will receive early intervention in the community. This program will recognize the long-term needs of our patients into childhood and adolescence, addressing the unique social, mental, and academic challenges that occur at these different points of development. The information collected prospectively through the clinic will allow us to look at outcomes and risk factors in this patient population.