Abstract：
BACKGROUND/PURPOSE:Quality improvement (QI) is critical to enhancing patient care. It is necessary to prioritize which QI initiatives are relevant to one's institution and practice, as implementation is resource-intensive. We have developed and implemented a streamlined process to identify QI opportunities in our practice. METHODS:We designed a web-based Pediatric and Infant Case Log and Outcomes (PICaLO) instrument using Research Electronic Data Capture (REDCap™) to record all surgical procedures for our practice. At the time of operation, a surgeon completes a case report form. An administrative assistant enters the data in PICaLO within 5-7days. Outcomes such as complications, deaths, and "occurrences" (readmissions, reoperations, transfers to ICU, ER visit, additional clinic visits) are recorded at the time of encounter, during M & M Conferences, and during follow-up clinic visits. Variables were chosen and defined based on national standards from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP), and Patient Based Learning Log. Occurrences are queried for potential QI initiatives. RESULTS:In 2012, 3597 patients were entered, totaling 5177 procedures. There were 220 complications, 278 occurrences, and 16 deaths. Specific QI opportunities were identified and put into place. CONCLUSION:Data on procedures and outcomes can be collected effectively in a pediatric surgery practice to delineate pertinent QI initiatives. PICaLO is recognized by the American Board of Surgery as a mechanism to meet Maintenance of Certification 4 criteria.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Arca MJ,Enters J,Christensen M,Jeziorczak P,Sato TT,Thielke R,Oldham KTdoi
10.1016/j.jpedsurg.2013.09.057subject
Has Abstractpub_date
2014-01-01 00:00:00pages
202-5; discussion 205-6issue
1eissn
0022-3468issn
1531-5037pii
S0022-3468(13)00776-8journal_volume
49pub_type
杂志文章abstract：BACKGROUND:Laparoscopic cholecystectomy is the standard surgical management of biliary disease in children, but there has been a paucity of studies addressing outcomes after pediatric cholecystectomies, particularly on a national level. We conducted the first study to address the effect of surgeon specialty and volume ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.10.054
更新日期：2012-04-01 00:00:00
abstract：:Persistent müllerian duct syndrome (PMDS) is a rare form of male pseudohermaphroditism. Bilateral fallopian tubes and a uterus occur with an otherwise normal male phenotype. Testicular neoplasm in PMDS has been reported, but malignant degeneration of the remnant female genitalia has only once been reported. We present...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.05.071
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND/PURPOSE:Anterior sacral meningocele (ASM) and presacral teratoma (PT) are related malformations. Both can have familial occurrence. Surgical treatment of occult cases is essential. Hence, it is important to screen the asymptomatic relatives. Plain radiograph of the sacrum to look for any bony abnormalities i...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.28860
更新日期：2001-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:The mechanism of fetal gastric dilation in gastroschisis is controversial. This study was designed to characterize changes in the contractile profile of strips of stomach from rats following experimental gastroschisis. METHODS:Pregnant Wistar rats were operated on day 18.5. Fetuses were divided into...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.11.011
更新日期：2013-02-01 00:00:00
abstract：BACKGROUND:A reliable metric of technical proficiency is indispensable to the training of fellows and residents. The purpose of this study was to determine whether cumulative sum (Cusum) has predictive validity in laparoscopic training. We hypothesized that Cusum would be a better predictor of technical ability in fund...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.10.049
更新日期：2016-04-01 00:00:00
abstract：:A 17-year-old boy with insulin-dependent diabetes mellitus developed ketoacidosis and transitory shock. After resolution of his metabolic imbalance, he developed an acute abdomen prompting exploratory surgery. A section of necrotic ileum was found and resected. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90798-c
更新日期：1992-09-01 00:00:00
abstract：:A simplified technique for the repair of gastroschisis without the need to excise the umbilicus or make a fascial incision has been developed. First, the abdominal wall is stretched and the viscera are reduced. Next, the skin and subcutaneous tissue are elevated from the fascia for 1.5 cm around the defect and the fas...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80361-x
更新日期：1986-09-01 00:00:00
abstract：INTRODUCTION:A parent is often present during anesthetic induction of their child. Some ask to see surgery. We sought views regarding the prospect of a parent in theater during surgery. METHODS:A questionnaire survey of parents, theater staff, and surgeons was used. Visual analog scales were also used. A standard erro...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.09.030
更新日期：2009-04-01 00:00:00
abstract：:Over 200 cases of colonic hemangioma have been reported, with more than 50% occurring in the rectosigmoid. These benign vascular neoplasms usually present in childhood, often with life-threatening hemorrhage. Lack of awareness of the condition continues to lead to errors in diagnosis and management, and may contribute...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80018-6
更新日期：1988-11-01 00:00:00
abstract：:A 13-year-old girl with multiple genitourinary malformations, incomplete bladder exstrophy, urethral duplication with single bladder, septate vagina, and total urinary incontinence is presented. Prior to admission she had undergone surgery for teratoma and calculi of the bladder and partial fecal incontinence. A conti...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(90)90534-g
更新日期：1990-12-01 00:00:00
abstract：:All pediatric trauma deaths occurring in metropolitan Toronto (population, 2.2 million) in 1986 were analyzed from the regional coroner's records. Injuries sustained were scored using the Abbreviated Injury Scale (1985; AIS) and Injury Severity Score (ISS). Victims with injuries graded AIS 6 (any region), AIS 5 head/n...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80312-4
更新日期：1989-01-01 00:00:00
abstract：:A girl with vertically acquired HIV infection presented with a 6-month history of dyspnea and chest pain. Computed tomography of the thorax showed a heterogenous mass measuring 13 × 9 × 17 cm located in the anterior mediastinum. Complete surgical resection was accomplished with no complications. The final diagnosis wa...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.06.009
更新日期：2011-09-01 00:00:00
abstract：:A premature infant is presented with acute appendicitis in a scrotal hernia causing localization of the inflammatory signs to the scrotum, and relatively early operation. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(78)80017-7
更新日期：1978-04-01 00:00:00
abstract：:This report describes a neonate with a very rare and an unusual variety of esophageal atresia and tracheoesophageal fistula. The anomaly consisted of esophageal atresia and double distal tracheoesophageal fistula. The two fistulae as well as part of the distal esophagus were made up of tracheobronchial tissues. The em...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90034-3
更新日期：1998-09-01 00:00:00
abstract：PURPOSE:The purpose of this study was 2-fold: to study the complications of neuroblastoma treatment and to establish surgical guidelines. MATERIALS AND METHODS:The medical records of 92 patients with neuroblastoma (stage 1 or 2, n = 33; stage 3, n = 21; stage 4, n = 31; stage 4S, n = 7) who had undergone surgery in ou...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.08.003
更新日期：2006-12-01 00:00:00
abstract：PURPOSE:Although gastroschisis infants usually have a good outcome, there remains a cohort of babies who fare poorly. We inquired whether the presence of bowel dilatation in utero is predictive of postnatal course in infants with gastroschisis. METHODS:We compared the clinical course of infants who had bowel dilatatio...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.03.033
更新日期：2011-06-01 00:00:00
abstract：:Infants with congenital diaphragmatic hernia (CDH) on extracorporeal membrane oxygenation (ECMO) can have initial lung atelectasis which, in survivors, gradually improves over time. To test the hypothesis that these patients could benefit from surfactant therapy, infants with CDH (born at > 34 weeks' gestation) on ECM...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0022-3468(94)90580-0
更新日期：1994-03-01 00:00:00
abstract：:Recently, interest has been expressed in the correction of diaphragmatic hernia in utero as a solution to the problem of high mortality from this condition. Before such a procedure can be adopted in the human, studies aimed at establishing the contribution such advanced techniques would make in reducing mortality are ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80010-x
更新日期：1984-02-01 00:00:00
abstract：:Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora's lesion, was first described by Nora et al. in 1983 as a rare, tumor-like lesion involving the bones of the hands and feet. Popliteal artery pseudoaneursyms in the pediatric population are also unusual. Here, we present a case of a young male with a p...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.09.052
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:The ultimate treatment for severe short bowel syndrome is small bowel transplantation (SBT). Current immunosuppression for SBT is relatively ineffective and toxic. Peptides derived from residues 75-84 of the HLA-B7 molecule are immunomodulatory in vitro, and in rodents, when combined with subtherapeutic dose...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90608-4
更新日期：1997-03-01 00:00:00
abstract：:Lung scanning using solubilized xenon 133 can provide important information concerning both pulmonary perfusion and ventilation. This technique proved valuable in establishing the diagnosis of congenital lobar emphysema in a 7-month-old baby. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80005-8
更新日期：1988-11-01 00:00:00
abstract：:Anatomically, diaphragmatic agenesis (DA) is the most extreme form of congenital diaphragmatic defect, but clinically it has not been defined separately from Bochdalek's hernia (BH). Between 1986 and 1992, the authors treated 55 neonates who had diaphragmatic defects. Forty-eight of these cases presented within 24 hou...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章
doi：10.1016/0022-3468(95)90599-5
更新日期：1995-01-01 00:00:00
abstract：:Twenty-four children with postoperative chylothorax were encountered among 1,264 consecutive thoracic operations over a 7-year period and form the basis of this study. Chylothorax was caused by direct lesion to the thoracic duct or lymphatic vessels in 17 patients and was associated with superior vena cava (SVC) obstr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90696-q
更新日期：1991-05-01 00:00:00
abstract：:Müllerian inhibiting substance (MIS), a gonadal hormone important in sexual differentiation, is high (10 to 70 ng/mL) in human male serum postnatally for several years before declining during the peripubertal period, but is undetectable in female serum until the onset of puberty. The sexually dimorphic secretion of MI...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90245-g
更新日期：1993-03-01 00:00:00
abstract：:The clinical picture of venous or arterial thrombosis in the presence of circulating antiphospholipid antibodies is referred to as the antiphospholipid syndrome. A 5-month-old baby girl who was quite healthy so far was referred to our clinic with irritability, vomiting, and abdominal distension for 30 hours. Surgical ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2003.09.026
更新日期：2004-01-01 00:00:00
abstract：PURPOSE:The aim of this study was to determine how to manage children with recurrence of intussusception. METHODS:Medical records of patients treated for intussusception from 1976 to 2008 at the Queen Sirikit National Institute of Child Health were reviewed. Information on patients who developed recurrent intussuscept...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.07.029
更新日期：2010-11-01 00:00:00
abstract：AIM:An enormous amount of information about pediatric surgical conditions is available on the World Wide Web (www). Our aim was to ascertain how many parents accessed the www and how useful they found the exercise. METHOD:Over a 2-month period, all parents attending the surgical outpatient clinics were asked to comple...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.10.003
更新日期：2007-02-01 00:00:00
abstract：:Gastric duplication cysts are rare. The usual presentation is an abdominal mass with vomiting. In this article we report on a case presenting as an acute abdomen. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80101-0
更新日期：1989-11-01 00:00:00
abstract：PURPOSE:To describe the incidence and outcomes to one-year in infants born with oesophageal atresia (OA) with no distal tracheoesophageal fistula within a population cohort. METHODS:A subgroup analysis of a prospective multicentre population cohort study was undertaken describing the outcomes of infants with OA and no...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/j.jpedsurg.2016.11.008
更新日期：2017-02-01 00:00:00
abstract：BACKGROUND/PURPOSE:The formation of congenital chordee penis in patients with or without hypospadias is multifactorial and not completely clear. In most cases, after release of all known causes of chordee, "residual" penile curvature can persist. The authors discuss the etiopathogenetic mechanisms of congenital chordee...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2002.35006
更新日期：2002-09-01 00:00:00
