1. Implement of Palatoplasty Enhanced Recovery ( PER) pathway for cleft palate repair after the audit from the Surgical Outcomes Monitoring and Improvement Program ( SOMIP).
- Author
-
Chan, Edwin Kin‐Wai, Lee, Kim‐Hung, Wong, Vicky Hei‐Yi, Tsui, Bess Siu‐Yan, Wong, Sammi Yuen‐Shan, Pang, Kristine Kit‐Yi, Mou, Jennifer Wai‐Cheung, and Tam, Peter Yuk‐Him
- Subjects
- *
CLEFT palate , *POSTOPERATIVE period , *LENGTH of stay in hospitals , *PEDIATRIC surgery , *SURGICAL complications , *SURGERY - Abstract
Aim Length of stay ( LOS) is an important outcome measure of the Surgical Outcomes Monitoring and Improvement Program ( SOMIP). After analyzing the outcomes of the first two SOMIP reports, we introduced the Palatoplasty Enhanced Recovery ( PER) pathway for primary cleft palate repair in 2012. We aim to study if the implementation of PER pathway can decrease the LOS without increasing the complication rate. Methods All children who underwent primary cleft palate repair from January 2008 to April 2015 were studied. PER pathway was introduced in January 2012. Demographics data, postoperative outcomes including the LOS, readmission, morbidity and oro-nasal fistula ( ONF) were compared between patients operated before (pre- PER) and after ( PER) the implementation of the pathway. Results Eighty five children were recruited in the study (29 PER and 56 pre- PER). There were no statistical differences in the age, sex, type of cleft palate and associated syndrome between the two groups. Incidence of ONF ( PER 13.8% vs pre- PER 8.9%, p = 0.490), morbidity (0% vs 5.4%, p = 0.204) and readmission (6.9% vs 3.6%, p = 0.493) were not statistically different. Median LOS (3 days vs 6 days, p < 0.0001) was significantly shorter in the PER group. Conclusions The implementation of the PER pathway for primary cleft palate repair significantly decreased the length of stay without an increase in morbidity and readmission. The SOMIP initiated the establishment of the PER pathway and the positive outcome can be reflected in subsequent SOMIP reports. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF