Finnish Pediatric Surgery Hub | From Centralization to Collective Learning and Sharing of Expertise | General pediatric surgeons from Finland's five neonatal surgery centers established the Finnish Pediatric Surgery Hub (FPSH) in 2021 | 40 surgeries | managed co-operatively by FPSH | 30 - local university hospitals | 10 - Helsinki University Hospital | 34 elective & 6 urgent cases | Most frequent underlying diagnoses | Anorectal malformations | Esophageal atresia | Hirschsprung disease | Reoperation 13% | Early post-op complications 30% (Clavien-Madadi ≤IIIB) | Conclusion: Preliminary findings suggest Finnish Pediatric Surgery Hub fosters safe surgical expertise sharing and collective learning. | https://pubmed.ncbi.nlm.nih.gov/39142954/ | Source: Pakarinen MP et. al. | Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland | @EmGootee MD | @StayCurrentMD | Cincinnati Children's | Journal of Pediatric Surgery
Finnish Pediatric Surgery Hub - From Centralization to Collective Learning and Sharing of Expertise
Infographic · Dec 2024 · 1 min read
In brief
In brief
Finland's nationwide pediatric surgery hub (FPSH) enabled five university hospitals to share expertise and perform complex neonatal surgeries cooperatively, with 75% performed locally. Early results from 40 cases showed 30% complication rate (all Clavien-Dindo ≤IIIB) with no association between complication rates and surgical location, demonstrating safe decentralized care through collaboration.
- National collaboration enabled 75% of complex pediatric surgeries to be performed safely at local university hospitals rather than centralized referral.
- Complication rates (30% overall, all grade IIIB or lower) were equivalent regardless of surgical location when expertise was shared collaboratively.
- Virtual case meetings and cooperative surgical teams allowed safe management of rare conditions like anorectal malformations and esophageal atresia.
- The hub model demonstrates that decentralized care with expert collaboration can maintain quality while improving access for families.
- Urgent cases were managed within 1-3 days through coordinated decision-making on optimal surgical location and team composition.
Written by the GCMD Library team from the infographic.
A teal and yellow infographic with a map of Finland at top, illustrated healthcare workers in the middle, and statistics displayed in colored sections. The layout flows from top to bottom with key metrics highlighted in large text. Icons include medical professionals, a patient in wheelchair, and surgical staff illustrations.
Aim of the study: Continuous surgical developments, growing awareness of patient representatives and limited health-care resources are pushing for innovative approaches to ensure equal high-quality pediatric surgical care. We aimed to describe early experiences and assess surgical safety of a novel nationwide pediatric surgery collaborative initiative.
Methods: In 2021, general pediatric surgeons representing all five independent university hospitals performing neonatal surgery in Finland initiated national collaboration, the Finnish pediatric surgery hub (FPSH), for sharing of surgical expertise and collective learning. For each case addressed by FPSH, place of care and surgical team were decided individually, and when deemed necessary, operations were performed in cooperation. Operations performed during 2021-2023 and associated early (<30 days) postoperative complications were analyzed according to Clavien-Madadi classification.
Results: Of the total 40 surgeries managed co-operatively by FPSH, 30 (75%) took place in local university hospitals and 10 in Helsinki University Hospital. There were 34 (85%) elective and 6 urgent cases, which were operated within median 1 (range, 1-3) days. Most frequent underlying diagnoses included anorectal malformations, esophageal atresia and Hirschsprung disease. Overall, 12 (30%) had any early postoperative complications, all Clavien-Madadi grade IIIB or lower, and five patients (13%) were reoperated. Rate or grade of complications was not associated with place of care. In addition to regular virtual case meetings, national care protocols and research projects were introduced.
Conclusion: These preliminary findings suggest that our national collaborative initiative, FPSH, not only provided practical and safe framework for sharing of surgical expertise but also for collective learning.