Multicenter Pediatric Surgery Quality Collaborative (PSQC) NSQIP pilot study: Pediatric colorectal surgery bundle...

Area of Science:

• Pediatric Surgery
• Surgical Quality Improvement
• Colorectal Surgery

Background:

• The Pediatric Surgery Quality Collaborative (PSQC) initiated a pilot study in 2023.
• The study utilized the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) platform.
• A 7-item perioperative colon bundle checklist was implemented to enhance surgical care.

Purpose of the Study:

• To analyze bundle compliance in a multicenter pediatric colorectal surgery initiative.
• To identify specific compliance rates for each checklist item.
• To assess the effectiveness of the colon bundle checklist in improving surgical outcomes.

Main Methods:

• A 7-item perioperative colon bundle checklist was implemented across multiple centers.
• Custom variables were created on the NSQIP-P platform to track checklist compliance.
• Compliance data for pediatric colorectal cases (January 2023-September 2024) were analyzed, comparing implementation and control groups over time.

Main Results:

• 361 cases were analyzed; implementation cases showed significantly better compliance than controls in most areas.
• Highest compliance was observed for preoperative antibiotic administration (90%), lowest for intraoperative anastomotic leak testing (62%).
• Mean bundle compliance score increased significantly over time in implementation cases (4.07 to 5.14, p=0.010), with notable improvements in specific practices.

Conclusions:

• This study represents the largest multicenter initiative assessing a colon bundle checklist for pediatric colorectal surgery using NSQIP-Pediatric data.
• Significant, though imperfect, compliance improvement over 21 months indicates a realistic adoption rate for multicenter quality initiatives.
• The findings support the utility of the colon bundle checklist in enhancing surgical quality and adherence to best practices in pediatric colorectal surgery.