Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction

Area of Science:

• Pediatric Emergency Medicine
• Radiology
• Quality Improvement

Background:

• Intussusception is a common pediatric surgical emergency.
• Successful non-operative reduction of intussusception allows for potential early discharge.
• Current protocols may not optimize emergency department (ED) discharge after reduction.

Purpose of the Study:

• To implement and evaluate a protocol for facilitating ED discharge after successful radiologic ileocolic intussusception reduction.
• To improve patient management and hospital resource utilization.

Main Methods:

• A multidisciplinary team developed a quality improvement protocol.
• Key components included patient education, standardized radiology reporting, in-ED observation with hydration challenges, and post-discharge follow-up calls.
• Patient outcomes and adherence to the protocol were tracked.

Main Results:

• Out of 80 identified patients, 34 did not qualify for immediate discharge.
• Of the 46 eligible patients, 30 (65.2%) were discharged directly from the ED.
• The protocol demonstrated improved adherence over time and was associated with hospital cost savings.

Conclusions:

• A multidisciplinary quality improvement project successfully integrated a protocol for ED discharge of intussusception patients post-reduction.
• The protocol, utilizing education, standardized reporting, and structured follow-up, proved sustainable in a high-volume pediatric referral center.