Quality improvement, education, and outcomes research

Abstract

Patient safety events for hospitalized children occur at a rate comparable to hospitalized adults. There are also many safety issues that are unique to children’s health care, which are related to the four Ds of childhood: developmental change, dependence on adults, different disease epidemiology, and unique demographics. Medication errors are the most common adverse events in hospitalized patients, the majority of which are associated with rotating general surgery residents. Standardized order sets for common pediatric surgical conditions and routine perioperative order sets reduce the potential for medication error, overall hospital charges, and length of stay. Surgical morbidity and mortality conference is the most important meeting for surgical education and quality assurance in the surgery department at teaching institutions. The educational value of the surgical M&M conference can be improved by applying several techniques including direct questioning of the audience, more thorough explanation of cases, questions directed to attending surgeons, the use of radiographic images, and teaching points specifically made for the medical students in attendance. NSQIP Pediatric is designed to measure the quality of surgical care within an institution utilizing prospective entry of patient risk and outcome data and the determination of risk-adjusted 30-day outcomes.