Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Operationalizing quality improvement in a pediatric surgical practice. J Pediatr Surg 2014 Jan;49(1):202-5; discussion 205-6



Pubmed ID




Scopus ID

2-s2.0-84892624386   16 Citations


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.

Author List

Arca MJ, Enters J, Christensen M, Jeziorczak P, Sato TT, Thielke R, Oldham KT


Keith T. Oldham MD Professor in the Surgery department at Medical College of Wisconsin
Thomas T. Sato MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Congresses as Topic
Databases, Factual
Electronic Health Records
Emergency Service, Hospital
Forms and Records Control
Information Dissemination
Office Visits
Postoperative Complications
Practice Management
Program Evaluation
Quality Improvement
Specialties, Surgical
Surgical Procedures, Operative