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Surgical Management of Meatal Stenosis with Meatoplasty

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Operationalizing quality improvement in a pediatric surgical practice.

Marjorie J Arca¹, Jessica Enters¹, Melissa Christensen¹

¹Division of Pediatric Surgery, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI.

Journal of Pediatric Surgery

|January 21, 2014

Summary

A streamlined process effectively identifies quality improvement (QI) opportunities in pediatric surgery. The Pediatric and Infant Case Log and Outcomes (PICaLO) system aids in prioritizing initiatives for enhanced patient care.

Keywords:

Case log Maintenance of certification Pediatric Quality improvement Surgery

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Area of Science:

Pediatric Surgery
Healthcare Quality Improvement
Surgical Outcomes Research

Background:

Quality improvement (QI) is essential for advancing patient care.
Prioritizing QI initiatives is crucial due to resource constraints.
A streamlined process was developed to identify QI opportunities in practice.

Purpose of the Study:

To develop and implement a streamlined process for identifying quality improvement opportunities in a pediatric surgery practice.
To effectively collect data on procedures and outcomes to guide QI initiatives.

Main Methods:

A web-based Pediatric and Infant Case Log and Outcomes (PICaLO) instrument was created using REDCap™.
Surgeons completed case report forms, with data entered by administrative staff.
Outcomes and 'occurrences' were recorded and queried for QI initiatives, using national standards (ACS NSQIP).

Main Results:

In 2012, data from 3597 patients and 5177 procedures were entered.
220 complications, 278 occurrences, and 16 deaths were recorded.
Specific QI opportunities were identified and implemented.

Conclusions:

The PICaLO system effectively collects procedure and outcome data to identify relevant QI initiatives in pediatric surgery.
PICaLO is recognized by the American Board of Surgery for Maintenance of Certification 4 criteria.