Developing a NSQIP module to measure outcomes in children’s surgical care: opportunity and challenge

Dillon, Peter W.; Hammermeister, Karl E.; Morrato, Elaine H.; Kempe, Allison; Oldham, Keith T.; Moss, Lawrence; Marchildon, Michael B.; Ziegler, Moritz M.; Steeger, Janet E.; Rowell, Kathy; Shiloach, Mira; Henderson, William G.

doi:10.1053/j.sempedsurg.2008.02.009

Cited by 127 publications

(76 citation statements)

References 42 publications

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“…[3][4][5] As the ACS-NSQIP-P has matured, the involvement of more surgical subspecialties has become a priority, and the leadership of the ASC-NSQIP-P has been welcoming and inclusive of surgical specialties as they realize the value of specialists within the scope of pediatric surgical care. 5 Surgical specialty participation is critical within the ASC-NSQIP-P because specialty content experts help to determine and shape how these data can be used to improve the care of patients in their fields.…”

mentioning

confidence: 99%

Identification of Opportunities for Quality Improvement and Outcome Measurement in Pediatric Otolaryngology

Shah

Stey

Jatana

et al. 2014

JAMA Otolaryngol Head Neck Surg

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While the overall rate of major postoperative morbidity in pediatric otolaryngology is low, areas for targeted quality-improvement interventions include tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage. Measurement of outcomes specific to otolaryngologic procedures will be necessary to further identify and measure the impact of quality-improvement initiatives in pediatric otolaryngology.

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mentioning

confidence: 99%

Identification of Opportunities for Quality Improvement and Outcome Measurement in Pediatric Otolaryngology

Shah

Stey

Jatana

et al. 2014

JAMA Otolaryngol Head Neck Surg

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show abstract

“…acsnsqip.org/about.jsp) is a prospective project organized by the American College of Surgeons in collaboration with the American Pediatric Surgical Association. 6 Participating hospitals employ dedicated medical record analysts who abstract randomly selected surgical charts for a large number of demographic and clinical variables. The NSQIP-P calculates rates of adverse events-such as surgical site infection, transfusion, or readmission within 30 days-for each participating institution that can be compared anonymously with other participating institutions.…”

confidence: 99%

Thirty-day outcomes of cerebrospinal fluid shunt surgery: data from the National Surgical Quality Improvement Program-Pediatrics

Piatt¹

2014

PED

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Object Cerebrospinal fluid shunts are the mainstay of the treatment of hydrocephalus. In past studies, outcomes of shunt surgery have been analyzed based on follow-up of 1 year or longer. The goal of the current study is to characterize 30-day shunt outcomes, to identify clinical risk factors for shunt infection and failure, and to develop statistical models that might be used for risk stratification. Methods Data for 2012 were obtained from the National Surgical Quality Improvement Program-Pediatrics (NSQIP-P) of the American College of Surgeons. Files with index surgical procedures for insertion or revision of a CSF shunt composed the study set. Returns to the operating room within 30 days for shunt infection and for shunt failure without infection were the study end points. Associations with a large number of potential clinical risk factors were analyzed on a univariate basis. Logistic regression was used for multivariate analysis. Results There were 1790 index surgical procedures analyzed. The overall rates of shunt infection and shunt failure without infection were 2.0% and 11.5%, respectively. Male sex, steroid use in the preceding 30 days, and nutritional support at the time of surgery were risk factors for shunt infection. Cardiac disease was a risk factor for shunt failure without infection, and initial shunt insertion, admission during the second quarter, and neuromuscular disease appeared to be protective. There was a weak association of increasing age with shunt failure without infection. Models based on these factors accounted for no more than 6% of observed variance. Construction of stable statistical models with internal validity for risk adjustment proved impossible. Conclusions The precision of the NSQIP-P dataset has allowed identification of risk factors for shunt infection and for shunt failure without infection that have not been documented previously. Thirty-day shunt outcomes may be useful quality metrics, possibly even without risk adjustment. Whether important variation in 30-day outcomes exists among institutions or among neurosurgeons is yet unknown.

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“…APSA in response to this movement has been both reactive and proactive. We have morphed our "Outcomes Committee" from one focused on the establishment of multiinstitutional evidence-based clinical research efforts to taking the initiative to partner with the American College of Surgeons in the development of a National Surgical Quality Improvement Program for children's surgery, a NSQIP-Pediatrics (NSQIP-P) [17,18]. This ACS/APSA partnership has enabled pediatric surgery on behalf of all of the surgical specialties rendering care to children, except congenital cardiac surgery and ophthalmology, to develop a risk-adjusted methodology to monitor and report hospitalbased morbidity and mortality at the institution level, comparing best performing to worst performing institutions.…”

Section: Clinical Carementioning

confidence: 99%

The innovation of success: the pediatric surgery and APSA response to “disruptive technologies”

Ziegler¹

2009

Journal of Pediatric Surgery

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Developing a NSQIP module to measure outcomes in children’s surgical care: opportunity and challenge

Cited by 127 publications

References 42 publications

Identification of Opportunities for Quality Improvement and Outcome Measurement in Pediatric Otolaryngology

Identification of Opportunities for Quality Improvement and Outcome Measurement in Pediatric Otolaryngology

Thirty-day outcomes of cerebrospinal fluid shunt surgery: data from the National Surgical Quality Improvement Program-Pediatrics

The innovation of success: the pediatric surgery and APSA response to “disruptive technologies”

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