Standardizing Appendicitis Care

Clinical Secretary Denise Allen and Dr. Helene Flageole are reviewing papers at a desk.

Appendicitis is a dangerous inflammation of the appendix, and surgery to remove the appendix is one of the most common pediatric surgical emergencies. A quality-improvement project called QUAPPE (Quality Assurance & Performance Improvement Project for Suspected Appendicitis), led by Dr. Helene Flageole and supported by 2017 Foundation gala proceeds, was aimed at standardizing the care provided to patients who were suspected of suffering from appendicitis.

“We see approximately 250 to 280 cases a year,” says Dr. Flageole. “Our goal was to standardize the process of caring for these patients in the Emergency Department.”

Donor-funded research

The study involved using an appendicitis score – a series of questions to determine if a patient required a standard ultrasound. Care teams then used a risk-assessment tool, in combination with the findings from the ultrasound, to determine if a patient was at a low or high risk of having appendicitis.

“Patients who are determined to be low risk are safe to go home,” explains Dr. Flageole. “Prior to QUAPPE, many of these children would have been admitted unnecessarily, which impacts our scarce resources.”

“Our goal was to standardize the process of caring for these patients in the Emergency Department.”

The study has resulted in a decreased number of CT scans being conducted, as ultrasounds have been found to be more effective at diagnosing appendicitis.

“We hope our process will be standardized in community hospitals throughout the region so patients aren’t transferred to McMaster Children’s Hospital for unnecessary diagnostic tests when they could safely go home,” says Dr. Flageole.