https://www.gosh.nhs.uk/conditions-and-treatments/clinical-outcomes/specialist-neonatal-and-paediatric-surgery-clinical-outcomes/
Specialist Neonatal and Paediatric Surgery clinical outcomes
Clinical outcomes are measurable changes in health, function or quality of life that result from our care. Constant review of our clinical outcomes establishes standards against which to continuously improve all aspects of our practice.
About the Specialist Neonatal and Paediatric Surgery service
The Specialist Neonatal and Paediatric Surgery (SNAPS) service at Great Ormond Street Hospital (GOSH) provides specialist surgical treatment for newborn babies and children with congenital (present at birth) conditions as well as diseases of the gastrointestinal tract and other abdominal problems including solid tumours.
The department has an excellent international reputation and continues to develop new ways of treating newborn babies and children, such as oesophageal replacement surgery and minimally invasive (keyhole) surgery.
The SNAPS department works closely with a number of other departments within GOSH, including Urology, Interventional Radiology, Gastroenterology, Oncology and Ear, Nose and Throat (ENT).
Referrals are made in most cases via local hospital consultants, community paediatricians or in exceptional circumstances via a GP.
Clinical outcome measures
1. Non-elective re-admission rate within 30 days to any specialty after a procedure under SNAPS
Complications resulting from surgery can occasionally cause patients to be readmitted to hospital. The rate of readmissions is a standard hospital outcome that is monitored to reduce complications and improve care. The table below shows the number of patients discharged from SNAPS who have a non-elective (emergency) readmission within 30 days of discharge (excludes day cases).
Numerator: number of inpatient discharges under SNAPS that have a subsequent non-elective readmission within 30 days of discharge from GOSH.
Denominator: number of all inpatient discharges from GOSH under SNAPS. Day cases are excluded.
Table 1 Non-elective re-admission rate within 30 days to any specialty after a procedure under SNAPS
| Year | Patients requiring non-elective readmission within 30 days | Total number of all inpatients discharged under SNAPS | Percentage of readmissions within 30 days |
|---|---|---|---|
| 2012/13 | 51 | 1,273 | 4.0% |
| 2013/14 | 50 | 1,309 | 3.8% |
| 2014/15 | 30 | 1,130 | 2.7% |
| 2015/16 | 40 | 1,064 | 3.8% |
| 2016/17 | 45 | 1,074 | 4.2% |
| 2017/18 | 40 | 1,057 | 3.8% |
| 2018/19 | 45 | 1,019 | 4.4% |
| 2019/20 | 22 | 794 | 2.8% |
| 2020/21 | 36 | 795 | 4.5% |
| 2021/22 | 30 | 855 | 3.5% |
| 2022/23 | 14 | 405 | 3.5% |
| 2023/24 | 23 | 763 | 3.0% |
| Total | 426 | 11,538 | 3.7% |
2. Unscheduled return to theatre within seven days under any specialty after a procedure under SNAPS
Due to the complexity of some operations or related to complications during surgery, a small number of patients may need further surgery that was unplanned. To help reduce this occurrence and its potential effects on outcome and patient experience, we monitor the rate of patients who return to theatre soon after a procedure. The table below shows the number of patients who have an unscheduled return to theatre within seven days of previous scheduled surgery under SNAPS.
Numerator: number of unscheduled theatres cases (any specialty) within seven days of previous scheduled theatre case under SNAPS.
Denominator: number of scheduled theatre cases under SNAPS.
Table 2 Unscheduled return to theatre within seven days under any specialty after a procedure under SNAPS
| Year | Patients returning unscheduled to theatre within 7 days | Total number of scheduled theatre cases under SNAPS | Percentage of patients returning unscheduled to theatre within 7 days |
|---|---|---|---|
| 2012/13 | 28 | 1,209 | 2.3% |
| 2013/14 | 24 | 1,235 | 1.9% |
| 2014/15 | 22 | 1,195 | 1.8% |
| 2015/16 | 16 | 1,168 | 1.4% |
| 2016/17 | 10 | 1,210 | 0.8% |
| 2017/18 | 14 | 1,191 | 1.2% |
| 2018/19 | 14 | 1,177 | 1.2% |
| 2019/20 | 10 | 962 | 1% |
| 2020/21 | 10 | 678 | 1.5% |
| 2021/22 | 7 | 932 | 0.8% |
| 2022/23 | 9 | 876 | 1% |
| 2023/24 | 8 | 1000 | 0.8% |
| Total | 172 | 12,833 | 1.3% |
References
Patch repair of congenital diaphragmatic hernia is not at risk of poor outcomes. J Pediatr Surg. Aug;55(8):1522-1527, 2020.
Potential Benefits of Laparoscopic Repair of Duodenal Atresia: Insights from a Retrospective Comparative Study. Eur J Pediatr Surg. Feb;30(1):33-38, 2020.
Thoracoscopic oesophageal atresia/tracheo-oesophageal fistula (OA/TOF) repair is associated with a higher stricture rate: a single institution's experience. Pediatr Surg Int. 37(3):397-40, Mar 2021.
Long-term surgical and patient-reported outcomes of Hirschsprung's Disease. J Pediatr Surg. 56(9):1502-1511, Sep 2021.
Laparoscopic inguinal hernia repair (LIHR): the benefit of the double stitch in the largest single-center experience. Pediatr Surg Int. Dec 8;40(1):17. Dec, 2023.
Short and Medium Term Outcomes of Open and laparoscopic Assisted oesophageal replacement Procedures. J Pediatr Surg; 59(2):192-196, Feb 2024.