General Surgery Outcomes

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Why Choose Us: General Surgery

Our Outcomes: The Results of Our Care

At Nemours, our pediatric general surgeons perform “general surgery” for children (sometimes just called “pediatric surgery”) on areas of the body other than the brain, bones and heart. So, if your child needs surgery of the chest, abdomen, gastrointestinal tract, blood vessels or skin, you may see one of our pediatric general surgeons. Specially trained in both surgery and pediatric surgery, we’re committed to performing the most effective and least invasive procedures with the fewest trips to the operating room.

Why Measuring Results Matters

To provide pediatric care that's among the safest and most effective, we measure our results and compare them to national rates. Why? So we can:

  • help you make decisions about your child’s care
  • be clear about our results
  • improve so we can consistently deliver better, safer care

Here are a few outcomes we track and focus on to improve the experience for both you and your child.

 

Preventing Wound Infections

Preventing Wound Infections


Making Sure Kids Don’t Get Infections After Surgery

When your child needs surgery, you probably aren’t thinking about infections in surgical wounds. You’re likely just focusing on the operation itself and hoping it helps correct your child’s condition. But, just like when your child gets an everyday cut or scrape, preventing infections in surgical wounds is important. When it comes to an operation, preventing wound infections is essential because it means a faster recovery and a shorter hospital stay. That’s why we track our “post-operative wound infection rate” (that’s the number of infections after surgery).

To help keep children from having complications like infections after their operation, we:

  • strictly follow proven patient care practices. We take great pride in our patient care, and strive for the highest standards of excellence in our procedures and techniques before, during and after surgery. This includes our thorough cleaning and sterilizing procedures, and our extra careful handling of the child’s incision (where the surgeon cut into the skin).
  • use, whenever possible, minimally invasive surgical procedures (which use tiny, camera-guided equipment and small incisions). Our high rate of minimally invasive surgical techniques, even in complex abdominal and thoracic (chest) procedures, helps decrease the wound size and wound infections.
  • give antibiotics and use other state-of-the-art infection prevention techniques before, during and/or after an operation as needed. This helps curb infections during and after the procedure.
  • review and discuss unusual infections and complications after surgery with every member of the division. We want to find out what happened and what, if anything, we could do to prevent a complication in the future.
  • encourage all of our patients' families to sign up and use MyNemours. The parent portal of our award-winning electronic health record system gives you secure access to your child’s records and allows you to communicate by email with your provider(s). So families can immediately report a problem and make sure it gets noticed and noted in the system so someone can contact you right away.
  • make a follow-up call within 24 hours after surgery to make sure everything is okay. We ask questions about how your child's feeling and how the surgical wound looks (and is healing) so that we can address any concerns as soon as possible.

 

Post-Operative (After Surgery) Wound Infections

3.8%

Overall general surgery

2.5%

Nonappendectomy procedures

Data source: Data collected for Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.) from the National Surgical Quality Improvement Program-Pediatric (ACS NSQIP Pediatric), Semiannual Report, July 1, 2016-June 30, 2017. A partnership of the American College of Surgeons and the American Pediatric Surgical Association, ACS NSQIP Pediatric has more than 100 children's surgical program participants across the country. Currently at Nemours, only duPont Hospital for Children is part of NSQIP and, when compared in the ACS NSQIP Pediatric system, performs overall as expected for children’s surgical programs. In 2019, Nemours Children's Hospital (in Orlando) will participate as well. Preliminary surgical data for Nemours Children's Hospital is as good as or very comparable to duPont Hospital for Children.

Helping Kids Stay Out of the Hospital

Helping Kids Stay Out of the Hospital


Preventing Hospital Readmissions After Surgery

Sometimes children with chronic or complex conditions have planned repeat hospitalizations for ongoing medical care. Sometimes children are admitted with new infections, respiratory problems, gastrointestinal illnesses, etc. However, it’s important to avoid as much as possible, potentially preventable admissions — such as hospital-acquired infections (when a patient gets an infection during surgery or a hospital stay) or returns to the hospital (readmissions) because a problem wasn’t properly recognized or treatment was incomplete. It’s important to minimize unplanned admissions (and readmissions) because they can:

  • interfere with your child’s and family’s life — cause missed school, work and important events (e.g., sports, vacations)
  • be costly to you, the parents, especially if you have co-pays or high deductible insurance

At Nemours, we want to make sure kids don't have to be admitted to the hospital after surgery. That’s why we:

  • stick to proper patient care procedures. Our pride and thoroughness in surgery and patient care help us achieve the best results — the first time — and reduce the need for readmissions.
  • schedule all follow-up appointments and tests after surgery as needed
  • provide clear educational materials and discharge instructions to families, including correct medications and doses
  • give families access to a Nemours physician for postdischarge questions (after a hospitalization or surgery) through our CareConnect telehealth service (available in the Delaware Valley)
  • encourage online communication through your child’s electronic health record — MyNemours for families

 

Unplanned Hospital Readmissions for General Surgery Issue Within 30 Days of Original Operation

2.9%

Unplanned readmissions

Data source: Data collected for Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.) from the National Surgical Quality Improvement Program-Pediatric (ACS NSQIP Pediatric), Semiannual Report, July 1, 2016-June 30, 2017. A partnership of the American College of Surgeons and the American Pediatric Surgical Association, ACS NSQIP Pediatric has more than 100 children's surgical program participants across the country. Currently at Nemours, only duPont Hospital for Children is part of NSQIP and, when compared in the ACS NSQIP Pediatric system, performs overall as expected for children’s surgical programs. In 2019, Nemours Children's Hospital (in Orlando) will participate as well. Preliminary surgical data for Nemours Children's Hospital is as good as or very comparable to duPont Hospital for Children.

Reducing Kids’ Exposure to Radiation

Reducing Kids’ Exposure to Radiation


Using Ultrasounds to Help Diagnose Appendicitis

Doctors often use a radiology (medical imaging) test to diagnose appendicitis (the inflammation of a small, finger-shaped sac of tissue in the lower-right abdomen). A computed tomography scan (also called a CT or CAT scan) is the usual test for appendicitis, but it does expose kids to a small amount of radiation. Radiation can theoretically be harmful in large doses. To help reduce the total radiation a child is exposed to in the long term, the American College of Radiology recommends ultrasound, which just uses sound waves and no radiation. Ultrasounds produce good images without an unnecessary delay or decrease in accuracy.

That’s why Nemours Children’s Specialty Care, Jacksonville and our collaborating hospital network (Wolfson Children’s Hospital and Baptist Health System) started a program in late 2015/early 2016 to reduce CT scans to diagnose appendicitis. Now, we have special trained ultrasound technicians performing ultrasounds to detect appendicitis. Our emergency department physicians choose ultrasounds instead of CT scans to evaluate children with abdominal pain/possible appendicitis — and our surgeons ask for ultrasound instead of CTs for the diagnosis of appendicitis. Since we started the program, we've seen an 11 percent reduction in CT scan use and we're now doing better than the national average.

 

Patients Receiving CT Scans for Appendicitis Diagnosis

32%

Before start of program*

21%

To date**

23%

National average (benchmark)

Data source: Data collected for Nemours Children's Specialty Care, Jacksonville (Jacksonville, Fla.) from the National Surgical Quality Improvement Program-Pediatric (ACS NSQIP Pediatric), Appendicitis Report, *Jan. 1, 2015-Dec. 31, 2015 and **Jan. 1, 2017-July 31, 2017. A partnership of the American College of Surgeons and the American Pediatric Surgical Association, ACS NSQIP Pediatric has more than 100 children's surgical program participants across the country.
Benchmark: ACS NSQIP Pediatric, Appendicitis Report, July 1, 2016-June 30, 2017.

 

Our Differentiators: What Sets Us Apart

Our Differentiators: What Sets Us Apart


Why Choose Nemours General Surgery

General surgery in children is much different than in adults. Not only are their bodies still growing and changing, but kids have different social and emotional challenges that only a pediatric team can fully address. Here are just some of the reasons families choose Nemours for their children’s general surgery care:

  • Experienced, highly skilled surgeons. Our pediatric surgeons are board-certified and fellowship-trained to provide the highest level of surgical and medical care for simple to complex conditions. We’re technically meticulous in our techniques (which contributes to our low complication rate), and our staff is very experienced with minimally invasive procedures.
  • World-class surgeons with the highest level of expertise. Our general surgeons have dual certifications and subspecialty training in a variety of pediatric conditions.
  • Best Doctors in America®. Many of our physicians are named to the list, year after year.
  • Collaborative, team approach to your child’s care. Our surgeons work closely with multispecialty teams built around your child’s condition, including neonatologists, otolaryngologists (ear, nose and throat, or ENT doctors), geneticists, speech-language therapists and anyone else your child may need to see. We also make sure your child’s primary care physician is always in the loop.
  • Close, personalized, family-centered care. We treat every child as we would our own. We also include you in every decision because we recognize that you know your child best. We work together to tend to your child’s physical, emotional and social needs before, during and after surgery.