Journal ArticleDOI
What's New in Pediatric Orthopaedic Quality, Safety, and Value? A Systematic Review With Results of the 2016 POSNA Quality, Safety, and Value Initiative (QSVI) Challenge.
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TLDR
Quality improvement efforts emphasizing provider education and safety monitoring can lead to a decrease in cast-related complications and increased scrutiny has been placed on the value of routine follow-up radiographs in pediatric fracture and spinal deformity care.Abstract:
Background Enhancing the safety, quality, and value of care provided is a point of emphasis for modern health care systems. We performed a review of recent literature to highlight those efforts relevant to pediatric musculoskeletal care. Methods We searched the PubMed database for all papers related to quality improvement, patient safety, and/or value in pediatric orthopaedics published from October 1, 2012 to October 31, 2017, yielding 193 papers. Results A total of 36 papers were selected for review based upon new findings. Papers were selected based on significant contributions in the following categories: casting safety, antibiotic stewardship/infection prevention, perioperative care pathways, blood conservation, venous thromboembolic disease prevention, and imaging safety/appropriateness. Conclusions There have been numerous advances in safety, quality, and value in pediatric orthopaedic care. Quality improvement efforts emphasizing provider education and safety monitoring can lead to a decrease in cast-related complications. Perioperative care pathways and bundles are associated with a decrease risk of surgical site infection and decreased length of stay in pediatric spinal deformity surgery. Increased scrutiny has been placed on the value of routine follow-up radiographs in pediatric fracture and spinal deformity care. Level of evidence Level 4-literature review.read more
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Impacto da campanha “Considere o Risco”, da Sociedade Brasileira de Ortopedia e Traumatologia, na percepção do risco e na utilização do checklist cirúrgico por ortopedistas brasileiros*
TL;DR: Na amostra pesquisada, ficou evidenciado that os esforcos da SBOT para a disseminacao do conhecimento do protocolo da Organizacao Mundial de Saude foram efetivos, reduzindo a quantidade of ortopedistas that o desconheciam de 65,3% (em 2012) para 20,7% ( e ampliando sua utilizac
Journal ArticleDOI
Variability in Antibiotic Treatment of Pediatric Surgical Site Infection After Spinal Fusion at A Single Institution.
Lara L Cohen,Craig M Birch,Danielle Cook,Daniel J. Hedequist,Lawrence I. Karlin,John B. Emans,Michael T. Hresko,Brian D. Snyder,Michael P. Glotzbecker +8 more
TL;DR: In this paper, the authors document variability in antibiotic regimens prescribed for acute and latent surgical site infections following posterior spine fusion (PSF) in children with idiopathic, neuromuscular, and syndromic scoliosis.
References
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Journal ArticleDOI
Building consensus: development of a Best Practice Guideline (BPG) for surgical site infection (SSI) prevention in high-risk pediatric spine surgery.
Michael G. Vitale,Matthew D. Riedel,Michael P. Glotzbecker,Hiroko Matsumoto,David P. Roye,Behrooz A. Akbarnia,Richard C. E. Anderson,Douglas L. Brockmeyer,John B. Emans,Mark Erickson,John M. Flynn,Lawrence G. Lenke,Stephen J. Lewis,Scott J. Luhmann,Lisa McLeod,Peter O. Newton,Ann-Christine Nyquist,Ann-Christine Nyquist,B. Stephens Richards,Suken A. Shah,David L. Skaggs,John T. Smith,Paul D. Sponseller,Daniel J. Sucato,Reinhard Zeller,Lisa Saiman,Lisa Saiman +26 more
TL;DR: It is the unsubstantiated opinion of the authors of the current paper that adherence to recommendations in the BPG will not only decrease variability in practice but also result in fewer SSI in high-risk children undergoing spinal fusion.
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Rapid Recovery Pathway After Spinal Fusion for Idiopathic Scoliosis
Wallis T. Muhly,Wallis T. Muhly,Wudbhav N. Sankar,Kelly A Ryan,Annette Norton,Lynne G. Maxwell,Lynne G. Maxwell,Theresa DiMaggio,Sharon B Farrell,Rachel Hughes,Alex L. Gornitzky,Ron Keren,Ron Keren,John J. McCloskey,John J. McCloskey,John M. Flynn,John M. Flynn +16 more
TL;DR: Implementation of a standardized RRP with multimodal pain management and early mobilization strategies resulted in reduced LOS without an increase in reported pain scores or readmissions.
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Best practices in intraoperative neuromonitoring in spine deformity surgery: Development of an intraoperative checklist to optimize response
Michael G. Vitale,David L. Skaggs,Gregory I. Pace,Margaret L. Wright,Hiroko Matsumoto,Richard C. E. Anderson,Douglas L. Brockmeyer,John P. Dormans,John B. Emans,Mark Erickson,John M. Flynn,Michael P. Glotzbecker,Kamal Ibrahim,Stephen J. Lewis,Scott J. Luhmann,Anil Mendiratta,B. Stephens Richards,James O. Sanders,Suken A. Shah,John T. Smith,Kit M. Song,Paul D. Sponseller,Daniel J. Sucato,David P. Roye,Lawrence G. Lenke +24 more
TL;DR: A consensus-based checklist to guide surgeon responses to intraoperative neuromonitoring (IONM) changes in patients with a stable spine and a consensus- based best practice guideline for IONM practice in the United States are developed.
Journal ArticleDOI
The relative efficacy of antifibrinolytics in adolescent idiopathic scoliosis: a prospective randomized trial.
Kushagra Verma,Thomas J. Errico,Chris Diefenbach,Christian Hoelscher,Austin Peters,Joseph Dryer,Tessa Huncke,Kirstin Boenigk,Baron S. Lonner +8 more
TL;DR: Overall, antifibrinolytics (tranexamic acid or epsilon-aminocaproic acid) reduced estimated blood loss, total blood losses, and the decline in hematocrit postoperatively compared with saline solution.
Journal ArticleDOI
Use of a Novel Pathway for Early Discharge Was Associated With a 48% Shorter Length of Stay After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.
Nicholas D. Fletcher,Lindsay M. Andras,David E. Lazarus,Robert J. Owen,Benjamin J. Geddes,Jessica Cao,David L. Skaggs,Timothy S. Oswald,Robert W. Bruce +8 more
TL;DR: Hospital stay was nearly 50% shorter in patients managed by the accelerated discharge (AD) pathway without any increase in readmissions or early complications, suggesting earlier discharge may reduce health care costs and allow an earlier return to normalcy for families.