Improving care through standardized treatment of spontaneous pneumothorax.
J Pediatr Surg
; 56(1): 55-60, 2021 Jan.
Article
em En
| MEDLINE
| ID: mdl-33139032
ABSTRACT
PURPOSE:
The objective of this quality improvement (QI) initiative was to implement a standardized clinical treatment protocol for patients presenting with primary spontaneous pneumothorax (PSP) in order to decrease hospital length of stay (LOS), diagnostic radiation exposure, and related cost.METHODS:
Baseline data from patients admitted with PSP from January 1, 2016 to July 31, 2018 were compared to data from patients managed using a newly developed evidence-based treatment pathway from August 1, 2018 to December 31, 2019. Standard QI methodology was used to track results.RESULTS:
Fifty-six episodes of PSP were observed during the baseline period and 40 episodes of PSP following initiation of the PSP protocol. The average LOS decreased from 4.5â¯days to 2.9â¯days. Patients underwent an average of 8.8 X-rays per admission preintervention versus 5.9 postintervention. The rate of CT scans decreased from 45% to 15% (pâ¯=â¯0.002). There was no significant difference in the rates of 30-day recurrence between the preintervention (13%) and postintervention (10%) groups (pâ¯=â¯0.7). Average admission costs per patient decreased by $1322 after adoption of the pathway.CONCLUSIONS:
Adoption of a standardized treatment protocol for PSP led to a reduction in LOS, diagnostic imaging utilization, and cost without increasing clinical recurrence. TYPE OF STUDY Quality improvement. LEVEL OF EVIDENCE Level III.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumotórax
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article