Increased capture of pediatric surgical complications utilizing a novel case-log web application to enhance quality improvement

TY - JOUR

T1 - Increased capture of pediatric surgical complications utilizing a novel case-log web application to enhance quality improvement

AU - Fisher, Jason C.

AU - Kuenzler, Keith A.

AU - Tomita, Sandra S.

AU - Sinha, Prashant

AU - Shah, Paresh

AU - Ginsburg, Howard B.

N1 - Publisher Copyright: © 2017 Elsevier Inc.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Purpose Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We developed a novel web application that improves accuracy and reduces barriers to documenting complications. Methods We deployed a custom web application that allows pediatric surgeons to maintain case logs. The program includes a module for entering complication data in real time. Reminders to enter outcome data occur at key postoperative intervals to optimize recall of events. Between October 1, 2014, and March 31, 2015, frequencies of surgical complications captured by the existing hospital reporting system were compared with data aggregated by our application. Results 780 cases were captured by the web application, compared with 276 cases registered by the hospital system. We observed an increase in the capture of major complications when compared to the hospital dataset (14 events vs. 4 events). Conclusions This web application improved real-time reporting of surgical complications, exceeding the accuracy of administrative datasets. Custom informatics solutions may help reduce barriers to self-reporting of adverse events and improve the data that presently inform pediatric surgical QI. Type of study Diagnostic study/Retrospective study. Level of evidence Level III – case control study.

AB - Purpose Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We developed a novel web application that improves accuracy and reduces barriers to documenting complications. Methods We deployed a custom web application that allows pediatric surgeons to maintain case logs. The program includes a module for entering complication data in real time. Reminders to enter outcome data occur at key postoperative intervals to optimize recall of events. Between October 1, 2014, and March 31, 2015, frequencies of surgical complications captured by the existing hospital reporting system were compared with data aggregated by our application. Results 780 cases were captured by the web application, compared with 276 cases registered by the hospital system. We observed an increase in the capture of major complications when compared to the hospital dataset (14 events vs. 4 events). Conclusions This web application improved real-time reporting of surgical complications, exceeding the accuracy of administrative datasets. Custom informatics solutions may help reduce barriers to self-reporting of adverse events and improve the data that presently inform pediatric surgical QI. Type of study Diagnostic study/Retrospective study. Level of evidence Level III – case control study.

KW - Electronic health record

KW - Informatics

KW - Pediatric

KW - Quality improvement

KW - Surgical complication

UR - https://www.scopus.com/pages/publications/85006744042

U2 - 10.1016/j.jpedsurg.2016.10.036

DO - 10.1016/j.jpedsurg.2016.10.036

M3 - Article

C2 - 27856010

SN - 0022-3468

VL - 52

SP - 166

EP - 171

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

IS - 1

ER -