Pediatric hernia repair: 1-stop shopping

Area of Science:

• Pediatric Surgery
• Outpatient Surgical Management
• Healthcare Delivery Optimization

Background:

• Multiple visits for pediatric surgical issues cause inconvenience, parental work absence, and missed school.
• Streamlining care pathways can improve patient and family experiences.

Purpose of the Study:

• To evaluate the feasibility of same-day outpatient evaluation and surgical treatment for select pediatric hernias.
• To test the hypothesis that proper previsit screening enables same-day service.

Main Methods:

• Developed criteria for identifying straightforward umbilical, epigastric, or inguinal hernias.
• Implemented scripting to offer same-day consultation and surgery.
• Collected data on patient numbers, procedures, insurance, and reimbursement; surveyed families postoperatively.

Main Results:

• 56 of 61 (92%) candidates had confirmed diagnoses; 50 underwent same-day repair.
• 72% had commercial insurance, 28% had Medicaid.
• Consultation fees were reimbursed in 78% of encounters; all surgical cases were reimbursed.
• High patient and family satisfaction was reported.

Conclusions:

• Same-day evaluation and surgical service for straightforward pediatric hernias are feasible.
• This model offers acceptable financial reimbursement and high parent satisfaction.
• Optimized previsit screening is key to successful same-day surgical care.