Standardized Perioperative Protocols and Variance in Pediatric Surgery

Area of Science:

• Pediatric Surgery
• Healthcare Quality Improvement
• Surgical Outcomes Research

Background:

• Standardized perioperative pathways are crucial for reducing variation and enhancing patient outcomes in surgery.
• Implementation of these pathways in pediatric surgery has lagged, necessitating broader evaluations.

Purpose of the Study:

• To assess the impact of the Minimizing Variance in Pediatric Surgery (MViPS) program on clinical outcomes, length of stay (LOS), and costs.
• To evaluate the effectiveness of a multi-institutional, multiprotocol initiative in pediatric surgery.

Main Methods:

• A cohort study comparing pediatric surgery patients before and after the implementation of the MViPS program across two academic tertiary referral centers.
• Data collected from October 2012 to November 2021, analyzing outcomes such as LOS, total hospital costs (THC), complications, and protocol compliance.

Main Results:

• The MViPS program demonstrated 82% protocol compliance.
• Post-implementation, study LOS decreased by 23% (191 hospital days), and total hospital costs (THC) were reduced by 10% ($266,709).
• Complication rates remained similar between pre- and post-protocol groups.

Conclusions:

• The MViPS initiative successfully reduced total hospital costs and length of stay in pediatric surgery.
• Standardized protocols are valuable for improving both outcomes and efficiency in pediatric surgical care across institutions.