Background Quality improvement efforts in pediatric surgery can positively impact both outcomes and cost. Purpose The use of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP)–Pediatrics was essential in determining where to focus our efforts. Methods Utilizing risk-adjusted outcomes data is the key driver behind our successes as a multidisciplinary team. This team, which now includes a parent representative, meets at least monthly to review data, identify trends and problems, propose new change ideas, identify barriers to change, and celebrate success. Detailed agendas and minutes are circulated to all team members to ensure a shared mental model. Results Since initiation in 2011, our efforts have resulted in a decrease in multiple morbidities, including surgical site infections, blood transfusions, preoperative Computerized Tomography use for patients undergoing appendectomy, unplanned reintubations, shorter lengths of stay, and fewer readmissions. Our improvement efforts resulted in an estimated cost savings of $1.5 million over a 2-year period (2015–2016). Conclusions Our team used NSQIP data to direct and guide quality improvements in patient care. Implications The business case for surgical quality comes from getting a return on investment in NSQIP with multidisciplinary teams led by surgeons and nurses.

Background: Inpatient surgical teams are challenged with treating complex patients, communicating across disciplines, educating trainees, and transitioning between the operating room, clinic, and inpatient unit. Systematic approaches to rounds are needed to perform these tasks effectively. Prior studies on nonsurgical units have shown that rounding checklists improve patient safety and trainee education. However, few studies have investigated the utility of checklists on surgical rounds.Objective: The purpose of this article is to synthesize the evidence regarding rounding checklists on inpatient surgical units, with a focus on structure, content, utilization, outcomes, and educational value.Methods: A narrative review was completed after a search of PubMed, Embase, and Cumulative Index of Nursing and Allied Health Literature in November 2020 using the following index terms and keywords: pediatrics, operative surgical procedures, surgery, perioperative period, teaching rounds, rounds, checklist, rounding tool, and rounding list. Results:We identified 11 relevant studies. Six were conducted on inpatient surgical units (54%), and five were conducted on medicine or critical care units (46%). The structure and content of checklists were varied, with most integrating subjective and objective findings. These studies show that rounding checklists improve the organization and completeness of rounds, interdisciplinary communication, documentation, adverse event rates, and educational opportunities. However, they also increase rounding time and require reinforcement for sustained compliance. Conclusions:The existing literature suggests rounding checklists can help create a culture of safety in which every team member, from nurse to attending, actively participates in improving patient care. We provide strategies to develop rounding checklists for pediatric surgical units.