Background: Recent changes in health care have begun to shift the industry from a volume-based value-based focus. This has led standardized pathways that decrease variability, improve outcomes, and cost. Although numerous studies described for adolescent idiopathic scoliosis (AIS), few demonstrated sustainability. We report effectiveness sustainability of pathway patients undergoing posterior spinal fusion AIS. Methods: A was developed implemented (in March 2015) at our pediatric hospital...

Summary Background Unnecessary testing for and ordering of blood products adds to overall healthcare costs. Objectives Determine intraoperative red cell ( RBC ) product utilization pediatric procedures costs associated with perioperative ordering. Methods A retrospective chart review captured transfusion data patients <19 years age who underwent noncardiac surgery over a 13‐month period at one tertiary care hospital. The main outcome measure was cost in undergoing that had zero rate...

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now widespread in most countries. As evidence regarding the clinical implications of SARS-CoV-2 continues to evolve, such data are crucial inform decision-making health care. Pediatric patients with viral infections known be vulnerable perioperative complications, often nature.1 Although pandemic has been raging for over a year, limited information available and anesthetic risks associated concurrent infection, particularly...

Children with SARS-CoV-2 infection are at increased risk for postanesthesia complications. There is minimal data regarding how long that elevated complication persists beyond initial diagnosis.We investigated complications in children within 90 days of completed a single-center, retrospective, case-control study pediatric patients confirmed undergoing anesthesia between January 3-October 7, 2020. Each positive patient was matched 1:2 by age and type procedure non-SARS-CoV-2 cohort. The...

A 28-year-old primigravida female with Loeys-Dietz syndrome presented at 36 weeks' gestation for scheduled primary elective cesarean delivery. The patient had clinical findings consistent this diagnosis, including mild aortic root dilation, chronic right vertebral artery dissection 2 intracerebral aneurysms, and small ectasias of the thecal sac in lumbar region. Pregnant patients have significant risks, aneurysm rupture, new formation, uterine rupture. After a thorough preoperative...

An abstract is not available for this content so a preview has been provided. Please use the Get access link above information on how to content.

Blood transfusions in patients with adolescent idiopathic scoliosis after fusion have been associated increased morbidity, mortality, and cost.The aim of this study was to evaluate the association between implementation blood-conservation strategies within perioperative surgical home on transfusion rates for undergoing spinal fusion.Two hundred thirteen (44 preperioperative home, 169 postperioperative home) who underwent posterior spine 23 June 2014, 30 July 2017, were enrolled case control...

There are well-documented racial and ethnic disparities in treatment perioperative outcomes for patients with adolescent idiopathic scoliosis.We hypothesize that the implementation of a coordinated care pathway pediatric undergoing posterior spinal fusion scoliosis may be associated reduction outcomes.This is retrospective pre- post-test cohort study who underwent at our institution between July 1, 2013 August 5, 2019. We implemented March 2015. Patient demographics included age, race,...

Introduction: There is a myriad of factors that can lead to temperature derangements in anesthetized children undergoing magnetic resonance imaging (MRI). Temperature abnormalities pediatric patients are associated with increased morbidity and mortality. Although some reports have looked at this topic, our knowledge, no studies continuously monitored throughout the MRI scan. The purpose study determine impact on body for using continuous measurement, identify patient risk develop...

None. The data that support the findings of this study are available on request from corresponding author. not publicly due to privacy or ethical restrictions.

None.

The emission and entrapment of greenhouse gases (GHG) inside the atmosphere is one leading causes global warming. Commonly administered anesthetics have warming potential up to 2,000 times greater than carbon dioxide. This Quality Improvement (QI) initiative aimed develop a set sustainability standards reduce volatile anesthetic GHG emissions costs at children's hospital.In January 2020, QI project team implemented education sessions for clinical staff on environmental impact anesthetics,...

The COVID-19 pandemic stopped healthcare in our tracks. thrust us into different ways of caring for and protecting patients employees. also exposed unacceptable disparities the management both microsystems macrosystems. Providing patient care context an ongoing highlighted dire need adaptability, transformation care, broad adoption quality improvement (QI) methodologies to optimize delivery safety. There are multiple examples organizations leveraging QI tools era.1–4 Though definitive data...

The association between hypothermia in the neonatal intensive care unit (NICU) patients and morbidity mortality is well described. Neonates are at higher risk of perioperative when compared to older children. Previous studies showed that quality improvement tools reduced postoperative NICU patients, but none sustained incidence rates <10%. As a single institution, we aimed reduce percentage temperatures < 36°C from 10% 6% over 6 months sustain for months.An interdisciplinary team created key...

The authors have no conflict of interest to declare. data that support the findings this study are available from corresponding author upon reasonable request.

Introduction: Spinal anesthesia has a long history as an effective and safe technique to avoid general in infants undergoing surgery. However, spinal was rarely used the primary anesthetic this population at our institution. This healthcare improvement initiative aimed increase percentage of successful placements circumcision, open orchidopexy, or hernia repair from 11% 50% by December 31, 2019, sustain that rate for 6 months. Methods: An interdisciplinary team created key driver diagram...

The purpose of this study was to quantify the wasted IV fentanyl in perioperative period at a pediatric hospital. Data collected from electronic charting were used calculate amount medication. We show significant wastage during period, and propose medication formulations that prevent financial, environmental, supply-chain complications.