Related Experiment Video
Updated: Mar 23, 2026
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Quality improvement in pediatric surgery
Danielle B Cameron1, Shawn J Rangel
1Department of Surgery, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA.
Insights
Quality in pediatric surgery has advanced through improved measurement and tools. Future efforts focus on expanding benchmarking and developing comprehensive, disease-specific care models for better outcomes.
Area of Science:
- Pediatric Surgery
- Healthcare Quality Improvement
- Surgical Outcomes Measurement
Background:
- Significant advancements in measuring and benchmarking quality in pediatric surgery over the last decade.
- Evolution of conceptual definitions of healthcare quality.
- Development of performance measurement platforms for pediatric surgical care.
Purpose of the Study:
- To review the evolution of quality definitions in healthcare.
- To examine existing performance benchmarking platforms in pediatric surgery.
- To identify quality improvement tools for pediatric surgical patients.
Main Methods:
- Review of current literature on quality in pediatric surgery.
- Analysis of existing pediatric surgical quality improvement programs and tools.
- Synthesis of data on performance benchmarking and value-based metrics.
Main Results:
- The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric (NSQIP-Ped) now provides risk-adjusted outcomes to over 70 hospitals, incorporating resource utilization and value-based metrics.
- Checklists and team-based communication tools show promise for enhancing surgical safety in children.
- Quality improvement methodologies like Lean and Six Sigma are improving efficiency and healthcare value.
Conclusions:
- Broader participation in benchmarking and knowledge-sharing collaboratives is essential.
- Development of multidisciplinary, disease-specific longitudinal care models is needed.
- Quality measurement should extend beyond the traditional 30-day perioperative period to encompass pre- and post-operative care.
Purpose Of Review:
The goal of this review is to provide updates on the evolution of conceptual definitions as they relate to quality in healthcare, existing measurement platforms for performance benchmarking in pediatric surgery, and available tools for quality improvement that are relevant to care of the pediatric surgical patient.
Recent Findings:
The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric has continued to evolve, now providing risk-adjusted safety outcomes data to over 70 hospitals and broadening its scope of quality measurement to include resource utilization and value-based metrics. Increasing use of checklists and other team-based communication tools show potential for making surgical care safer for children, and thoughtful application of quality improvement methods such as Lean methodology, six-sigma and others are helping to improve efficiency and increase healthcare value. Finally, efforts to define minimal resource standards for pediatric surgical care holds promise to improve outcomes for neonates and other children with complex surgical needs.
Summary:
Over the past decade, significant progress has been made in our ability to measure, benchmark and improve quality in pediatric surgery. Future efforts will need to facilitate broader participation in benchmarking programs and knowledge-sharing collaboratives, and to develop multidisciplinary, 'disease-specific' longitudinal care models where quality measurement extends before and beyond the 'traditional' 30-day perioperative period.
