Finnish Pediatric Surgery Hub - From Centralization to Collective Learning and Sharing of Expertise
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Mikko P. Pakarinen, Topi Luoto, Susanna Nuutinen, Arimatias Raitio, Esko Tahkola, Antti Koivusalo
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 per-formed in cooperation. Operations performed during 2021e2023 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, 1e3) 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
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Does creating a collaborative initiative help with providing high-quality pediatric surgical care? I'm Lizzie Lee from Cincinnati Children's Hospital, and this is an article you should know about. In 2021, pediatric surgeons from Finland's five neonatal surgery centers established the Finnish Pediatric Surgery Hub. They did 34 elective and six urgent cases total, with the most frequent diagnoses including anorectal malformations, esophageal atresia, and Hirschprung disease. They had regular monthly virtual meetings to present new patients, discuss complex cases, and follow up on patients after surgery. Their findings suggest that the Finnish Pediatric Surgery Hub fosters an effective and safe place for sharing surgical expertise and learning. Let us know what you think in the comments below and stay tuned for more articles that you should know about.