Neurosurgery Outcomes

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Why Choose Us: Neurosurgery

Our Outcomes: The Results of Our Care

Nemours board-certified pediatric neurosurgeons are experts in injuries and conditions of the brain, skull, spinal cord, spinal column and nerves throughout the entire body. We perform precise, state-of-the-art pediatric neurosurgery procedures for kids of all ages, from newborns to teens. Our team also includes advanced practice nurses, physician assistants, therapists, specialists and nurses, who use advanced technologies to diagnose, treat and provide ongoing care to kids with neurosurgical needs. We’ll be with you and your child through recovery, condition management and follow-up for as long as you need us.

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 couple of outcomes we track and focus on to improve the experience for both you and your child.

 

Preventing Infections After Surgery

Preventing Infections After Surgery


Making Sure Kids Don’t Get Infections After Surgery

Hydrocephalus, the most common pediatric neurosurgical disorder, occurs when there’s swelling in the brain due to excess buildup of cerebrospinal fluid (CSF). Cerebral shunts (special tubes surgically implanted in the brain to help it drain fluid) are commonly used to treat hydrocephalus. Sometimes bacteria can enter the CSF and affect the shunt, where the bacteria can spread.

If your child needs shunt surgery, you probably aren’t thinking about infections. 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 the shunt is important. Avoiding infections is essential because it means a faster recovery and a shorter hospital stay. To help keep children from having complications like infections after their operation, we:

  • Strictly follow an implant infection prevention checklist. These procedures have been shown to help reduce infection.
  • 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 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.
  • 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.
  • 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.

 

Post-Operative (After Neurosurgery) Shunt Infections

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Shunt infections out of 43 cases sampled for review*

*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 Neurosurgery

Sometimes kids 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 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 unexpectedly admitted or readmitted to the hospital after surgery by:

  • scheduling follow-up appointments and tests after surgery
  • providing clear educational materials and discharge instructions to families, including correct medications and doses
  • giving families access to a Nemours physician for post-discharge questions through our CareConnect telehealth service (available in the Delaware Valley)
  • encouraging online communication through your child’s electronic health record — MyNemours for families

 

Unplanned Hospital Readmissions for a Neurosurgery Issue Within 30 Days of Original Operation

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Unplanned readmissions out of 43 cases sampled for review*

*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.

Our Differentiators: What Sets Us Apart

Our Differentiators: What Sets Us Apart


Why Choose Nemours Neurosurgery

Neurosurgery in children is much different than in adults. Not only are kids’ bodies and minds still growing and changing, but children have different social and emotional challenges that only a pediatric team can fully address. At Nemours, we provide comprehensive, compassionate care for your child’s physical, cognitive and emotional needs before, during and after neurosurgery. Here are just some of the other reasons families choose Nemours for their children’s neurosurgery care:

  • Experienced, highly skilled neurosurgeons. Our pediatric neurosurgeons are board-certified and fellowship-trained to provide the highest level of surgical and medical care for simple to complex conditions. We’re true perfectionists in our techniques, which contributes to our low complication rate.
  • Expertise in minimally invasive operations. One type of procedure is called, "endoscopic third ventriculostomy" (or "ETV"). This operation treats hydrocephalus by making a small hole in the bottom of the third ventricle (one of the spaces in the brain) to let out the extra cerebrospinal fluid. The operation was further refined to include a "choroid plexus coagulation" (or "CPC"). The choroid plexus is the part of the brain that makes cerebrospinal fluid, and coagulation of the choroid plexus stops the brain from making so much of it. Nemours neurosurgeons use ETV-CPC to treat hydrocephalus in newborns and small infants who would otherwise need shunts for the rest of their lives. 
  • Collaborative, team approach to your child’s care. Our neurosurgeons work closely with multispecialty teams built around your child’s condition, from neurologists and orthopedists, to developmental and behavioral health experts, radiologists and anyone else your child may need to see.
  • Care coordination and help every step of the way. We help you navigate your child’s care. And, if you see multiple specialists, we work together to coordinate appointments for the same day, at the same place.
  • Close, personalized care for families. We treat every child as we would our own, and 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.