TY - JOUR
T1 - Minimizing variance in pediatric gastrostomy
T2 - Does standardized perioperative feeding plan decrease cost and improve outcomes?
AU - Sunstrom, Rachel
AU - Hamilton, Nicholas
AU - Fialkowski, Elizabeth
AU - Lofberg, Katrine
AU - McKee, Julie
AU - Sims, Thomas
AU - Krishnaswami, Sanjay
AU - Azarow, Kenneth
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Background A protocol for laparoscopic gastrostomy placement was implemented which specified perioperative antibiotics, feeding regimens, and discharge criteria. Our hypothesis was that hospital cost could be decreased, whereas at the same time improving or maintaining patient outcomes. Methods Data were collected on consecutive patients beginning 6 months after implementation of our protocol. We recorded surgeon compliance, patient outcomes (as defined by 30-day NSQIP complication rates), and cost of initial hospitalization, which was then compare to a 6-month historical control period. Results Our control group n = 26 and protocol group n = 39. Length of stay was shorter in the protocol group (P ≤.05 by nonparametric analysis). The complication rate was similar in both groups (23% control vs 15% protocol, P =.43). Initial hospital costs were not different. Surgeon compliance to protocol was 82%. Conclusions A standard protocol is achievable for gastrostomy tube management. After implementation of our protocol, we were able to show a significant decrease in length of stay, whereas maintaining quality.
AB - Background A protocol for laparoscopic gastrostomy placement was implemented which specified perioperative antibiotics, feeding regimens, and discharge criteria. Our hypothesis was that hospital cost could be decreased, whereas at the same time improving or maintaining patient outcomes. Methods Data were collected on consecutive patients beginning 6 months after implementation of our protocol. We recorded surgeon compliance, patient outcomes (as defined by 30-day NSQIP complication rates), and cost of initial hospitalization, which was then compare to a 6-month historical control period. Results Our control group n = 26 and protocol group n = 39. Length of stay was shorter in the protocol group (P ≤.05 by nonparametric analysis). The complication rate was similar in both groups (23% control vs 15% protocol, P =.43). Initial hospital costs were not different. Surgeon compliance to protocol was 82%. Conclusions A standard protocol is achievable for gastrostomy tube management. After implementation of our protocol, we were able to show a significant decrease in length of stay, whereas maintaining quality.
KW - Gastrostomy
KW - Minimizing variance
KW - Pediatric surgery
KW - Standardizing care
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U2 - 10.1016/j.amjsurg.2016.02.004
DO - 10.1016/j.amjsurg.2016.02.004
M3 - Article
C2 - 26995593
AN - SCOPUS:84961226560
SN - 0002-9610
VL - 211
SP - 948
EP - 953
JO - American journal of surgery
JF - American journal of surgery
IS - 5
ER -