Welcome to the APSA Quality and Safety Committee Oncology Toolkit. This page is intended to help anyone who is interested in quality improvement pertaining to pediatric surgical oncology.
Available toolkit projects are listed below. Many of the approaches described are evidence based - some are not. These approaches have not been approved by APSA.
Nationwide Children’s Hospital
These surgeons were interested in improving ovarian salvage rates for benign ovarian masses as they had previously shown that their rate was very low - especially among pediatric surgery faculty. They utilized quality improvement methodology and interventions such as creation of an ovarian mass algorithm, multi-disciplinary education, implementation of ovarian salvage techniques and standardized pelvic ultrasound reporting [1][2].
Protocol
Stakeholders: pediatric surgeons, pediatric/adolescent gynecologists, oncologists, radiologists, pathologists
Challenges and solutions: “buy-in” from those pediatric surgeons who are newer to ovarian sparing surgery; education and collegial and collaborative environment between surgeons and gynecologists; adoption of “co-surgeons” until all surgeons comfortable with the technique.
Submitted by Jennifer Aldrink
Texas Children’s Hospital
As part of its Quality and Patient Safety Program, TCH created an evidence based outcomes center (EBOC) that takes a subject of importance and carefully and critically evaluates literature, involves in house content experts and generates a “clinical standard” for the institution. The subject of how to deal with children with anterior mediastinal masses is an important and complicated one. This was taken on by the team at TCH. An evidence based report and resulting algorithm was generated. [3][4]
Protocol
Evidence summary and algorithm of management of anterior mediastinal masses
Stakeholders: anesthesiologists, pediatric surgeons, oncologists (practitioners who are involved in the work-up and management of anterior mediastinal masses)
Challenges and solutions: multidisciplinary education and adoption of the information.
Submitted by Rahul Baijal