Falkiewicz Marissa K, Su Ruthie, Jones Susan L, Shayan Muhammad, Farhat Walid A, Peters Megan E
Department of Urology, University of Wisconsin, Madison, Wisconsin.
Department of Pediatric Surgery and Trauma, University of Wisconsin, Madison, Wisconsin.
Urol Pract. 2023 Mar;10(2):171-176. doi: 10.1097/UPJ.0000000000000364. Epub 2023 Feb 9.
The operating room is an increasingly expensive and limited resource. The aim of this study was to evaluate the efficacy, safety, cost, and parental satisfaction of transitioning minor pediatric urology procedures from an operating room setting to a pediatric sedation unit.
Minor urological procedures were transitioned from the operating room to the pediatric sedation unit if they could be completed in 20 minutes using minimal instrumentation. Information regarding patient demographics, procedure characteristics, rates of success and complications, and cost were collected from urology procedures performed in the pediatric sedation unit between August 2019 and September 2021. Patient demographics and cost data from the most common urology procedures performed in the pediatric sedation unit were compared to data from historical controls of cases occurring in the operating room. Parent surveys were performed following the completion of procedures in the pediatric sedation unit.
A total of 103 patients, ranging from 6-207 months old (mean 72 months), underwent procedures in the pediatric sedation unit. The most common procedures were lysis of adhesions and meatotomy. All procedures were successfully completed with procedural sedation, and no procedure was complicated by serious sedation adverse events. The cost reduction for lysis of adhesions in the pediatric sedation unit was 53.5% compared to the operating room, and meatotomy was 27.9%, leading to approximately $57,000 cost savings per year. Fifty families completed a follow-up satisfaction survey, and 83% of parents were satisfied with the care their family received.
The pediatric sedation unit can provide a successful and cost-efficient alternative to the operating room while preserving safety and high rates of parental satisfaction.
