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078. Quality Improvement in Pediatric Neurosurgery

Authors: Annie Drapeau, MD, FAANS

Introduction:
Quality Improvement (QI) is considered to be methods used to implement sustainable meaningful change and improve patient outcomes. QI is becoming an integral part of contemporary healthcare. This study sought to define the current QI landscape in pediatric neurosurgery.Methods: A Redcap survey was sent through the AANS/CNS Section on Pediatric Neurosurgery email distribution list. Responses remained anonymous. Questions addressed: 1) training and participation in QI; 2) QI infrastructure; 3) QI program incentives; and 4) general opinions on the NSQIP database, QI topics, and QI productivity.
Results:
Responses were received from 126 individuals (19.5% return rate). The majority practiced in an academic setting (60.2%) at a free-standing pediatric hospital (64.2%). Participation in QI projects was high (81.1%), but only 24.6% had formal QI training. Only 36.9% had institutional requirements for QI work; the majority of those were only required to participate as a project team member (79.5%). Nearly half of all respondents did not receive incentives or institutional support for QI. The majority agreed (“strongly” and “somewhat agree”) with the following: • a QI course would be beneficial (74.7%); • there is interest for QI projects presentations at the annual Pediatric Section meeting (87.8%); • QI projects should be considered for publication in neurosurgery journals (87.8%); and • there is a need for national quality metrics (80.8%). Only 26.3% felt that NSQIP was a useful QI guide (“strongly” and “somewhat agree”). Frequently suggested QI topics were infection prevention and overall rates, hydrocephalus-related topics, standardized treatment algorithms for common disorders, team communication, pediatric neurosurgery specific database, access to care and interprofessional education.
Conclusion:
Areas of opportunity include specialty-specific QI education, tactics for obtaining support to build QI infrastructure, increased visibility of QI work within pediatric neurosurgery, and review of available registries to provide readily available data relevant to this specialty.