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In 2008, a multidisciplinary team at the Medical Center of Georgia, Macon, began a one-year Plan-Do-Study-Act (PDSA) cycle to implement a high-quality pediatric surgery service line. The PDSA team defined goals, objectives, and measurable performance metrics and then reviewed cases and aggregated data monthly to identify and improve clinical, process, instrument, and supply problems as well as patient transfer issues. The PDSA cycle led to improvements in team performance, communication, and patient transfer and decreased the number of problems associated with instruments, supplies, equipment, and surgeon tardiness.

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