Role of patient and family engagement in quality improvement for pediatric surgery
Seminars in Pediatric Surgery. 2023 Apr;32(2):151281.
doi: 10.1016/j.sempedsurg.2023.151281
There exists a persistent gap in involvement of patients and families in Quality Improvement (QI) initiatives in Pediatric Surgery. This article proposes how to bridge these gaps to create continuous, system-wide opportunities to evaluate and improve care.
Completion of an Enhanced Recovery Program in a Pediatric Ambulatory Surgery Center: A Quality Improvement Initiative
Anesthesia & Analgesia. 2022 Dec 1;135(6):1271-1281.
doi: 10.1213/ANE.0000000000006256.
Inside Out Medicine implemented a patient flow model that incorporates an enhanced recovery program (ERP). This QI project demonstrated the feasibility of pediatric ERP in an ambulatory surgical setting. Furthermore, a center-wide approach was shown to be possible. Using the patient flow model and platform for delivering education, preoperative and postoperative surveys.
The team had expanded the pool of active ERAS elements from 11 to 16 (out of a possible 19 elements). The mean PACU length of stay (LOS) demonstrated significant reduction. No change was seen for the mean maximum pain score in PACU or surgical complication rates. Patient/family satisfaction scores were high and sustained throughout the period of study (91.1% ± 5.7%). Patient/family and provider engagement/compliance were high.
Treatment compliance in amblyopia: A mini-review and description of a novel online platform for compliance tracking
Survey of Ophthalmology.2022 Nov-Dec;67(6):1685-1697.
doi: 10.1016/j.survophthal.2022.08.003
Inside Out Medicine's patient flow models increased treatment compliance an d improved outcomes in amblyopia treatment. With no up-front investment on the part of the clinic or costs to families, Inside Out Medicine enables visibility into patient compliance at home and consultative opportunities. The patient flow model included real-time, daily data on patient compliance and improved communication between clinical staff and patients/families. Anecdotally, clinical staff reported that the new flow and platform allowed for greater confidence in management for providers and built a stronger provider-family relationship with parents who embrace its use.
Parent Perspectives on Readiness for Discharge Home after Neonatal Intensive Care Unit Admission
The Journal of Pediatrics. 2019 Feb:205:98-104.e4.
doi: 10.1016/j.jpeds.2018.08.086
Parents described many ways the system could have better prepared them and connected them with essential resources. Summarizing the voices of the parents who participated in this study, we have compiled a series of practical recommendations for clinicians to use in daily practice to help parents feel prepared and confident for the transition home from the NICU.
Resource utilization after implementing a hospital-wide standardized feeding tube placement pathway
Journal of Pediatric Surgery. Volume 51, Issue 10, 1674 - 1679.
doi: 10.1016/j.jpedsurg.2016.05.012.
IOM implemented a patient flow model as part of a hospital-wide standardized pathway for feeding device placement. This study compares hospital resource utilization before and after pathway implementation. Prior to implementation, 174/298 (58.4%) patients required additional hospital resource utilization compared to 60/143 (42.0%), corresponding to a 38% reduced risk of a subsequent feeding tube related event.
Improving Pediatric Patient Readiness for Gastrostomy Placement via Caregiver's Preconsult Involvement
Journal of Pediatric Surgical Nursing. 2019;8(4):91-96.
doi: 10.1097/JPS.0000000000000223.
Inside Out Medicine implemented a patient flow model to increase patient readiness for surgery and improve efficiency for clinical staff. The new model decreased the need for additional presurgical visits by 62%. Patient/family readiness to schedule surgery immediately following the consult increased 36%. Nurse clinic preparation time decreased by 28%.