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Feb 07, 2017
Increase Effectiveness and Efficiency
Idiopathic scoliosis is a common spinal deformity in which the spine becomes curved. Sometimes the curve must be fixed surgically and recovery can be long and painful. Historically, recovery in the hospital was five to seven days with slow rehabilitation and over reliance on IV opioids like morphine. Evidence suggested that we could do better by increasing our use of non-opioid pain medicine and encouraging patients to become more active earlier after surgery.
A team of orthopedic surgeons, anesthesiologists, advanced practice nurses, physical therapists, pharmacists and nurses at Children's Hospital of Philadelphia (CHOP) developed a clinical pathway to accelerate the return of functional recovery following spine fusion surgery. Using a multidisciplinary approach, the team developed and implemented a new pain management strategy and recovery pathway which has improved the quality of recovery and reduced overall length of stay to three to four days in this surgical population.
The median hospital length of stay for children who had this surgery decreased by two days, from 5.5 to 3.5 days.
As adherence to pathway increased, patients were removed from the Patient-controlled analgesia (PCA) pump sooner and were seen by Physical Therapy (PT) quicker.
Updated October, 2018
An initiative was implemented so that infants with fever who met low-risk criteria could be safely discharged home without a spinal tap.
An initiative was implemented to increase the discharge rate of patients with sickle cell disease to improve the quality of life.