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The past, present and future of ACS NSQIP-Pediatric: Evolution from a quality registry to a comparative quality
Jacqueline M Saito1, Douglas C Barnhart2, Catherine Grant3
1Division of Pediatric Surgery, Washington University, St. Louis, MO, USA.
Insights
The American College of Surgeons
Area of Science:
- Pediatric Surgery
- Quality Improvement
- Healthcare Data Analytics
Background:
- Reliable data is essential for quality and process improvement (QI/PI) in pediatric surgical care.
- The American College of Surgeons' National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) has provided comparative data since 2012.
- Continuous program evolution has occurred over the past decade.
Purpose of the Study:
- To describe the evolution and advancements of the NSQIP-Pediatric program.
- To highlight the program's role in supporting QI/PI in children's surgery.
- To outline future directions for enhancing pediatric surgical care data.
Main Methods:
- Iterative changes to case inclusion and data collection, analysis, and reporting.
- Development of new datasets for specific pediatric procedures (e.g., appendectomy, spinal fusion).
- Incorporation of additional risk factors, outcomes, and resource utilization metrics.
Main Results:
- Enhanced clinical relevance and healthcare value through specialized datasets.
- Development of process measures for urgent diagnoses and antibiotic prophylaxis.
- NSQIP-Pediatric has become a mature, dynamic program supporting QI/PI.
Conclusions:
- NSQIP-Pediatric has successfully evolved to meet the needs of the pediatric surgical community.
- The program's data supports risk-adjusted outcomes analysis and QI/PI.
- Future efforts will focus on patient-centered care and healthcare equity.
Abstract:
Quality and process improvement (QI/PI) in children's surgical care require reliable data across the care continuum. Since 2012, the American College of Surgeons' (ACS) National Surgical Quality Improvement Program-Pediatric (NSQIP-Pediatric) has supported QI/PI by providing participating hospitals with risk-adjusted, comparative data regarding postoperative outcomes for multiple surgical specialties. To advance this goal over the past decade, iterative changes have been introduced to case inclusion and data collection, analysis and reporting. New datasets for specific procedures, such as appendectomy, spinal fusion for scoliosis, vesicoureteral reflux procedures, and tracheostomy in children less than 2 years old, have incorporated additional risk factors and outcomes to enhance the clinical relevance of data, and resource utilization to consider healthcare value. Recently, process measures for urgent surgical diagnoses and surgical antibiotic prophylaxis variables have been developed to promote timely and appropriate care. While a mature program, NSQIP-Pediatric remains dynamic and responsive to meet the needs of the surgical community. Future directions include introduction of variables and analyses to address patient-centered care and healthcare equity.
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