Quality Measures for Pediatric Orthopaedic Surgery: A Systematic Review

Area of Science:

• Orthopaedic Surgery
• Pediatric Care
• Healthcare Quality Improvement

Background:

• Quality measures are crucial for assessing and improving healthcare delivery.
• Existing orthopaedic surgery quality measures have identified gaps, necessitating new measure development.
• This study focuses on identifying the current quality measure portfolio in pediatric orthopaedic surgery.

Purpose of the Study:

• To identify and characterize the existing quality measures and candidate measures for pediatric orthopaedic surgery.
• To categorize these measures based on structure, process, and outcome.
• To classify measures according to the National Quality Strategy priorities.

Main Methods:

• A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Databases searched included PubMed/MEDLINE, EMBASE, and specific organizational databases (AAOS, NQF, AHRQ).
• Quality measures were categorized by type (structure, process, outcome) and National Quality Strategy priority.

Main Results:

• A total of 18 quality measures and candidate measures were identified for pediatric orthopaedic surgery.
• The identified measures primarily addressed conditions like supracondylar humerus fractures and hip dysplasia.
• The portfolio consisted of 10 process measures and 8 outcome measures, with no structure measures; 50% aligned with effective clinical care.

Conclusions:

• The current landscape of quality measures for pediatric orthopaedic surgery is limited.
• Process measures are disproportionately represented among the available quality metrics.
• Pediatric orthopaedic surgeons should prioritize developing outcome and structure measures to enhance quality assessment.