Measuring Pediatric Bronchoscopy Outcomes Using an Electronic Medical Record

Area of Science:

• Pediatric Pulmonology
• Healthcare Informatics
• Quality Improvement

Background:

• Bronchoscopy procedures require robust tracking for safety, quality, and regulatory compliance.
• Electronic Medical Record (EMR) systems offer a potential platform for comprehensive procedural data capture.

Purpose of the Study:

• To develop and validate a method for evaluating flexible bronchoscopy utilization and outcomes within an existing EMR system at a children's hospital.

Main Methods:

• A custom bronchoscopy procedure note was integrated into the EMR (Epic Systems Corporation).
• Data tracked included demographics, bronchoscopist, coordinated procedures, and patient outcomes.
• Unplanned outcomes and readmissions were electronically monitored and reviewed by a quality team.

Main Results:

• Over 2.5 years, 1,297 procedures on 1,161 pediatric patients were analyzed.
• The overall rate of unplanned outcomes was 2.1% (27 events).
• Patients undergoing multiple same-day procedures had a higher risk of unplanned outcomes (78%), particularly those outside the aerodigestive clinic.

Conclusions:

• EMR systems can effectively track procedural outcomes for flexible bronchoscopy.
• Unplanned outcomes following flexible bronchoscopy are infrequent in this pediatric population.
• While multiple procedures increase risk, coordinated care through multidisciplinary clinics mitigates this elevated risk.