Orthopedics Outcomes

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Why Choose Us: Orthopedics

Our Outcomes: The Results of Our Care

Nemours has one of the largest and most widely respected pediatric orthopedics programs in the United States — and the world. As international leaders in pediatric orthopedic research and care, our orthopedic physicians help correct or prevent deformities, disorders or injuries of the skeleton and any related muscles, tendons and ligaments. Our pediatric orthopedic surgeons and sports medicine physicians treat kids with all types of orthopedic issues, from sports-related injuries and scoliosis (curvature of the spine) to more complex disorders such as cerebral palsy and skeletal dysplasia (dwarfism). Parents come from across the country and around the globe for our orthopedic care completely dedicated to kids.

Why Measuring Results Matters

To provide pediatric care that's among the safest and most effective, we measure and track our results. 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.

 

Reducing Scoliosis Wound Infections

Reducing Scoliosis Wound Infections


Making Sure Kids Don’t Get Infections After Scoliosis Surgery

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

To help keep children from having complications like infections after their scoliosis operation, we make every effort before surgery to reduce the chances of infection and actively educate families about infection prevention and what to look for. We also:

  • Use improved surgical techniques and systems that help prevent the wound from becoming infected, reduce blood loss, and decrease pain after surgery. We also use improved closure systems to enhance the strength and integrity of surgical incisions after surgery.
  • Give antibiotics before, during and/or after an operation as needed to help curb infections during and after the procedure.
  • Make a follow-up call within 24 hours after you go home from the hospital 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.
  • 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.
  • Use online doctors' visits (CareConnect) frequently to monitor postoperative (after surgery) patients who live far away.
  • 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.

 

Wound Infections After Scoliosis Surgery

0%

Idiopathic scoliosis surgery*

6.25%

Nonidiopathic scoliosis surgery**

Data source and benchmark: 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.
*“Idiopathic” means the cause of the child's scoliosis is unknown, but it is most likely genetic.
**"Nonidiopathic" means the cause of the scoliosis is known.

Helping Kids Stay Out of the Hospital

Helping Kids Stay Out of the Hospital


Preventing Hospital Readmissions After Scoliosis Surgery

Sometimes children who've had scoliosis surgery may be 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

To prevent infections after scoliosis surgery, we give antibiotics, perform skin prep, test for possible resistant bacterial infections (like methicillin-resistant Staphylococcus aureus/MRSA), and limit traffic in the operating room. After surgery, kids have therapy to get them moving quickly. And to prevent constipation, we put children on a bowel regimen (e.g., stool softeners, increased fiber).

Communication with families and close follow-ups also are key to keeping kids out of the hospital:

  • 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 postdischarge questions through our CareConnect online doctors' visits (available in the Delaware Valley)
  • encouraging online communication through your child’s electronic health record — MyNemours for families

 

Unplanned Hospital Readmissions After Scoliosis Surgery

1.4%

Idiopathic scoliosis surgery*

8.75%

Nonidiopathic scoliosis surgery**

Data source and benchmark: 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.
*“Idiopathic” means the cause of the child's scoliosis is unknown, but it is most likely genetic.
**"Nonidiopathic" means the cause of the scoliosis is known.

Our Differentiators: What Sets Us Apart

Our Differentiators: What Sets Us Apart


Why Choose Nemours Orthopedics

Since 1940, Nemours has been world-renowned for delivering advanced pediatric orthopedic care. Orthopedics for kids and teens is much different than orthopedics for adults. That’s because children’s bodies are still growing and changing, and they have different social and emotional challenges that only a pediatric team can fully address. At Nemours, our pediatric orthopedic physicians, advanced practice nurses, physician assistants, nurses, therapists and technicians are specially trained and experienced in caring for kids — and only kids. And we’re backed by more than 30 medical specialties that also specialize in caring for children and teens.

Here are just some of the other reasons families choose Nemours for their children’s orthopedic care:

  • Advancing research in pediatric orthopedics. Nemours doctors and researchers are actively involved in research and clinical trials to look for better ways to diagnose and treat childhood orthopedic diseases such as skeletal dysplasia, hip dysplasia, scoliosis and sports medicine injuries.
  • Subspecialty programs dedicated to caring for kids with specific orthopedic or neuromuscular conditions. Our clinics allow our pediatric orthopedics teams to work alongside other pediatric specialists, nurse practitioners, licensed clinical social workers and more to give kids comprehensive, coordinated care. You can often visit multiple providers on the same day, in the same place.
  • Top 10 children’s hospital for orthopedics. Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., is consistently recognized by U.S. News & World Report as one of the best children’s hospitals in the country for orthopedic treatment and care.
  • Award-winning physicians. Year after year, many on our team are recognized in “Best Doctors in America®” and local magazines as “Top Doctors” in our regions.
  • Experienced, highly skilled orthopedic surgeons. We’re board-certified and fellowship-trained to provide the highest level of surgical and medical care for simple to complex conditions. We’re technically precise in our techniques (which contributes to our low complication rates). And our staff is very experienced with minimally invasive procedures that help kids recover faster and get back home sooner.
  • Established surgical processes to improve safety and care before, during and after surgery — to reduce the risk of infections and the need for blood transfusions, prevent brain and nerve issues during surgery, improve pain management without narcotics, and strive for rapid recovery to help kids get home as quickly as possible.
  • Expert providers recognized for our medical contributions. We’re active in local, national and international professional societies. We also regularly share our knowledge at scientific meetings and in peer-reviewed medical journals.
  • Personalized, family-centered care. 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 throughout your child's treatment.