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Pediatric surgical wait priority score (pSWAPS): Modifying a health system's adult-based elective surgery

Bethany J Slater1, Michael T Cappello2, Mark M Butterly3

  • 1Department of Surgery, University of Chicago Medicine and Biological Sciences, 5841 S. Maryland Avenue, Chicago, IL 60637, United States.

Journal of Pediatric Surgery
|January 23, 2021
PubMed

Insights

A new pediatric scoring system (pSWAPS) effectively triages and prioritizes elective surgeries during the COVID-19 pandemic. This tool ensures safe reintroduction of procedures amidst resource constraints.

Area of Science:

  • Pediatric Surgery
  • Health Systems Management
  • Epidemiology

Background:

  • COVID-19 pandemic necessitated cancellation of elective surgeries due to transmission risks and resource diversion.
  • Stabilization of cases led to a need for a system to triage and prioritize surgical scheduling.

Purpose of the Study:

  • To develop and evaluate a pediatric scoring system (pSWAPS) for triaging elective surgical cases.
  • To assess the feasibility and effectiveness of pSWAPS in resource-constrained environments.

Main Methods:

  • A universal scoring system (SWAPS) was adapted for pediatrics (pSWAPS), incorporating resource, patient, and urgency factors.
  • Interrater reliability was assessed using Fleiss' Kappa coefficient with four surgeons.
  • The pSWAPS system was implemented for two months in two operating rooms with varying resource restrictions.

Main Results:

  • Eighteen factors contributed to the pSWAPS score (0-120).
  • Over a two-month period, 359 procedures were screened across two campuses (Oak Lawn and Park Ridge).
  • Average pSWAPS scores were 37.9 (Oak Lawn) and 54.3 (Park Ridge); immediate priority cases were successfully scheduled and completed.

Conclusions:

  • The pSWAPS system is a flexible and simple tool for prioritizing elective surgeries.
  • It effectively facilitated the safe reintroduction of procedures during the COVID-19 pandemic.
  • pSWAPS can be a valuable tool for managing surgical scheduling during future surges.
Abstract

Keywords:
COVID-19Elective surgeryPediatric SWAPSScoring system

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