Idiopathic scoliosis is the most common form of spinal deformity. Causing a curve in the spine, it typically occurs between age 10 and when a child is fully grown.
The orthopedic surgery group at Akron Children’s Hospital recognized there was tremendous variation in the preoperative, intraoperative and postoperative care of patients with this form of scoliosis. This was because surgeons were still referencing historical practice preferences of six individual surgeons—and the guidelines were not current or evidence-based. The group needed to update these so they could standardize care and optimize value for patients by providing improved pain control, expediting recovery and decreasing length of stay—all without negatively impacting readmission rates.
To tackle this challenge, the hospital worked to implement a pathway that allowed patients to receive standardized preoperative surgical clearance and optimization, standardized anesthetic management and multimodality pain management, and postoperative admission to a single, specialized regular nursing floor with immediate mobilization, dietary initiation and co-management by the hospitalist service. Order sets—standardized, evidence-based guidelines in the EHR—were created to facilitate compliance with these pathways, including preoperative, anesthesia and pain management, and postoperative inpatient, as well as standardized discharge instructions.
As a result, Akron Children’s Hospital was able to decrease length of stay for idiopathic scoliosis patients by 50%—with no adverse impact on postoperative complications. Patients with idiopathic scoliosis are now cared for on a single floor, with fully utilized order sets standardized to support quality care.
An economic benefit to patients and payers was also achieved, with a 12% decrease in costs. In comparison to the previous year, patient charges were reduced by $16,500, and direct costs for patients decreased $10,300.
The HIMSS Davies Award of Excellence recognizes the thoughtful application of health information and technology to substantially improve clinical care delivery, patient outcomes and population health around the world. The Davies Awards program promotes HIMSS’s vision and mission by recognizing and sharing use cases, model practices and lessons learned on how to improve health and wellness through the power of information and technology.
“Utilizing information and technology tools to develop a care pathway, Akron Children’s Hospital lays the groundwork for ensuring that pediatric idiopathic scoliosis patients receive the highest standard of care and are best positioned to make a full recovery,” said Jonathan French, CPHIMS, SHIMSS, senior director of quality and patient safety initiatives at HIMSS. “The pathway makes it easier for orthopedic surgeons to meet the standard of care, resulting in better outcomes and lower costs from less time in the hospital. HIMSS is proud to recognize Akron Children’s Hospital as a Davies Award of Excellence recipient.”
“Akron Children’s Hospital is honored to receive the HIMSS Davies Award,” said Michael Bigham, MD, chief quality officer at Akron Children’s Hospital. “Delivering high-quality care is at the core of our hospital’s mission. We are proud of how we have been able to leverage health information and technology to support our amazing providers and staff in delivering consistent, exceptional care for our patients and their families.”
“The HIMSS Davies Award is a tremendous achievement for Akron Children’s Hospital,” said Sarah Rush, MD, chief medical information officer and director of neuro-oncology at Akron Children’s Hospital. “We are continually evaluating ways to better utilize information technology to support and enhance the high-quality care we deliver to our patients.”
See the full list of 2019 Davies Award winners.
Updated March 6, 2020