title: Increased capture of pediatric surgical complications utilizing a novel case-log web application to enhance quality improvement.
abstract: OBJECTIVE
  Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We developed a novel web application that improves accuracy and reduces barriers to documenting complications.
  
  
  METHODS
  We deployed a custom web application that allows pediatric surgeons to maintain case logs. The program includes a module for entering complication data in real time. Reminders to enter outcome data occur at key postoperative intervals to optimize recall of events. Between October 1, 2014, and March 31, 2015, frequencies of surgical complications captured by the existing hospital reporting system were compared with data aggregated by our application.
  
  
  RESULTS
  780 cases were captured by the web application, compared with 276 cases registered by the hospital system. We observed an increase in the capture of major complications when compared to the hospital dataset (14 events vs. 4 events).
  
  
  CONCLUSIONS
  This web application improved real-time reporting of surgical complications, exceeding the accuracy of administrative datasets. Custom informatics solutions may help reduce barriers to self-reporting of adverse events and improve the data that presently inform pediatric surgical QI.
  
  
  METHODS
  Diagnostic study/Retrospective study.
  
  
  METHODS
  Level III - case control study.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, NYU Langone Medical Center, NYU School of Medicine, New York, NY. Electronic address: jason.fisher@nyumc.org.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Fisher
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, NYU Langone Medical Center, NYU School of Medicine, New York, NY.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Kuenzler
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, NYU Langone Medical Center, NYU School of Medicine, New York, NY.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Tomita
authors.affiliation: Division of General Surgery, Department of Surgery, NYU Langone Medical Center, NYU School of Medicine, New York, NY.
authors.forename: Prashant
authors.initials: P
authors.lastname: Sinha
authors.affiliation: Division of General Surgery, Department of Surgery, NYU Langone Medical Center, NYU School of Medicine, New York, NY.
authors.forename: Paresh
authors.initials: P
authors.lastname: Shah
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, NYU Langone Medical Center, NYU School of Medicine, New York, NY.
authors.forename: Howard B
authors.initials: HB
authors.lastname: Ginsburg
mesh_terms: D016022:Case-Control Studies; D004282:Documentation / Q000379:methods* / Q000592:standards; D057286:Electronic Health Records / Q000592:standards*; D006801:Humans; D010372:Pediatrics; D011183:Postoperative Complications; D058996:Quality Improvement; D012042:Registries; D012189:Retrospective Studies; D012984:Software
keywords: Electronic health record; Informatics; Pediatric; Quality improvement; Surgical complication