Quality indicators in pediatric orthopaedic surgery: a systematic review

Area of Science:

• Health Services Research
• Pediatric Orthopaedics
• Quality Improvement

Background:

• Measuring health system quality is a growing priority for various stakeholders.
• Quality indicators (QIs) are measurable outcomes used to assess and improve healthcare.
• QIs facilitate local quality improvement initiatives and track changes over time.

Purpose of the Study:

• To identify evidence-based quality indicators for pediatric orthopaedic care.
• To evaluate existing quality indicators for their applicability in pediatric orthopaedics.

Main Methods:

• Literature search using keywords: "quality indicators," "orthopaedic surgery," and "pediatric."
• Systematic study selection based on title, abstract, and full-text review.
• Included 13 articles from 604 identified citations, with 8 focusing solely on pediatric patients.

Main Results:

• Mortality and postoperative complications were the most frequently reported quality indicators.
• Reoperation and readmission rates were also documented.
• Patient-centered quality indicators were reported less frequently.

Conclusions:

• Mortality and complication rates may have limited applicability in pediatrics due to their rarity.
• Patient-centered quality indicators show promise but have limited published use.
• Patient-centered outcomes, surgeon-defined outcomes, and cost-effectiveness are vital for evaluating pediatric orthopaedic care quality.