Evidence map›Paper›PMID 32656466›Full record

ArticlePediatric quality & safety

Impact of a Standardized Clinical Pathway for Suspected and Confirmed Ileocolic Intussusception.

Corinne E Shubin, Lori E Rutman, A Luana Stanescu, Surabhi B Vora, George T Drugas, Michael G Leu, Rebekah A Burns

Open access · diamondAbstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Corinne E ShubinDepartment of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
Lori E RutmanDepartment of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
A Luana StanescuDepartment of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
Surabhi B VoraDepartment of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
George T DrugasDepartment of Surgery, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
Michael G LeuDepartment of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
Rebekah A BurnsDepartment of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
Seattle Children's Hospital · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClinical pathways for specific diagnoses may improve patient outcomes, decrease resource utilization, and diminish costs. This study examines the impact of a clinical pathway for emergency department (ED) care of suspected and confirmed pediatric ileocolic intussusception.

methodsOur multidisciplinary team designed an intussusception clinical pathway and implemented it in a tertiary children's hospital ED in October 2016. Process measures included the proportion of patients who underwent abdominal radiography, had laboratory studies, received antibiotics, or required admission following reduction of intussusception. The primary outcome measure was the cost per encounter. Balancing measures included unplanned ED visits within 72 hours of discharge. Data analyzed compared 24 months before and 21 months following pathway implementation.

resultsAfter pathway implementation, the use of abdominal radiography in patients with suspected intussusception decreased from 50% to 12%. In patients with confirmed intussusception, laboratory studies decreased from 58% to 25%, antibiotic use decreased from 100% to 2%, and hospital admissions decreased from 100% to 12%. The average cost per encounter for confirmed intussusception decreased from $6,724 to $2,975. There was a small increase in unplanned returns to the ED within 72 hours but no increase in readmissions after pathway implementation.

conclusionImplementation of a standardized ED pathway for the management of suspected and confirmed pediatric ileocolic intussusception is associated with a reduction in abdominal radiographs, improved antibiotic stewardship, reduction in laboratory studies, fewer inpatient admissions, and decreased cost, with no compromise in patient safety.

Identifiers

PMID32656466
PMCPMC7297403
OpenAlexW3031714865

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.