A Dedicated Team for Scoliosis Surgery

Increase Effectiveness and Efficiency

Why is this important?

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. 

What we did

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.   

Results

Hospital Length of Stay following Pathway Implementation

The median hospital length of stay for children who had this surgery decreased by two days, from 5.5 to 3.5 days.

Median Time (in days) to Achieve Patient Milestones

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 January, 2018