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

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• 作者：Jason C. Fisher^a ; ^{jason.fisher@nyumc.org} ; Keith A. Kuenzler^a ; Sandra S. Tomita^a ; Prashant Sinha^b ; Paresh Shah^b ; Howard B. Ginsburg^a
• 关键词：Surgical complication ; Informatics ; Quality improvement ; Electronic health record ; Pediatric
• 刊名：Journal of Pediatric Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：52
• 期：1
• 页码：166-171
• 全文大小：1200 K
• 卷排序：52

文摘

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.MethodsWe 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.Results780 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).ConclusionsThis 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 studyDiagnostic study/Retrospective study.Level of evidenceLevel III – case control study.