Pediatric Gastrostomy Tube Placement: Lessons Learned from High-performing Institutions through Structured Interviews

Area of Science:

• Pediatric Surgery
• Healthcare Quality Improvement
• Patient Outcomes

Background:

• Gastrostomy tube (GT) placement is a common pediatric procedure with high complication rates.
• Significant variations in readmission and ER visit rates exist across children's hospitals.
• High-performing institutions offer opportunities to identify best practices for GT care.

Purpose of the Study:

• To identify common practices at high-performing pediatric centers for gastrostomy tube (GT) care.
• To understand factors associated with optimal outcomes in pediatric GT placement.
• To inform strategies for improving GT care quality.

Main Methods:

• Structured interviews were conducted with surgeons and nurses at 8 high-performing pediatric centers.
• Interviews focused on GT education, technical placement, and postoperative management.
• Quantitative data were summarized, and qualitative responses underwent content analysis.

Main Results:

• Common practices include standardized education, readily available support (phone/clinic), and family empowerment for troubleshooting.
• Significant variation exists in operative techniques and postoperative care.
• Participants emphasized education, availability, and empowerment over technical aspects for optimal outcomes.

Conclusions:

• Common themes among centers with favorable GT placement outcomes were identified.
• Key components associated with optimal outcomes include education, availability, and empowerment.
• Understanding these components is crucial for improving pediatric GT care quality.